PD43-08 A NEPHRECTOMY SPECIFIC RESPIRATORY FAILURE INDEX USING A NATIONAL MULTI-CENTER DATASET

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You have accessJournal of UrologyCME1 Apr 2023PD43-08 A NEPHRECTOMY SPECIFIC RESPIRATORY FAILURE INDEX USING A NATIONAL MULTI-CENTER DATASET Christian Habib Ayoub, Jose M. EL-Asmar, Adnan EL-Achkar, Ali Dakroub, Elia Abou Chawareb, Layane EL-Khoury, Hani Tamim, Viviane Chalhoub, and Albert EL Hajj Christian Habib AyoubChristian Habib Ayoub More articles by this author , Jose M. EL-AsmarJose M. EL-Asmar More articles by this author , Adnan EL-AchkarAdnan EL-Achkar More articles by this author , Ali DakroubAli Dakroub More articles by this author , Elia Abou ChawarebElia Abou Chawareb More articles by this author , Layane EL-KhouryLayane EL-Khoury More articles by this author , Hani TamimHani Tamim More articles by this author , Viviane ChalhoubViviane Chalhoub More articles by this author , and Albert EL HajjAlbert EL Hajj More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003353.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nephrectomy, either partial, simple, or radical, is the treatment of various renal pathologies that entails significant morbidity and mortality. Post-operative pulmonary failure is a major complication of nephrectomy that may lead to severe morbidity and mortality. We aimed to derive a nephrectomy specific post-operative respiratory failure index. METHODS: We used the American College of Surgeons – National Surgical Quality Improvement Program database to select patients who underwent nephrectomy between the years 2005 and 2019. The outcome of interest was post-operative respiratory failure (PRF) defined as any incidence of unplanned intubation intraoperatively or postoperatively or requiring mechanical ventilation 48-hours after surgery. A multivariable logistic regression model was constructed, and model calibration and performance were assessed using a ROC analysis and the Hosmer-Lemeshow test. Finally, we derived the Nephrectomy Specific Respiratory Failure (NSRF) Index and compared it to Gupta’s index. RESULTS: Our cohort included 79,526 patients that underwent nephrectomy of which 965 patients developed PRF. The final NSRF model encompassed ten variables: age, smoking status, American society of anesthesiology class, abnormal creatinine (≥1.5 mg/dL), anemia (<36%), functional health status, chronic obstructive pulmonary disease, surgical approach, emergency case, and obesity (≥40 kg/m2). The NSRF ROC analysis provided C-statistic=0.78, calibration R2=0.99 and proper goodness of fit. In comparison, the C-statistics of Gupta’s index was found to be 0.71 (p-value <0.001). CONCLUSIONS: The NSRF is a procedure tailored index for predicting post-operative respiratory failure. This index can be used in the pre-operative setting to help identify high risk patients who will require additional respiratory evaluation and preparation for their surgery. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1121 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Habib Ayoub More articles by this author Jose M. EL-Asmar More articles by this author Adnan EL-Achkar More articles by this author Ali Dakroub More articles by this author Elia Abou Chawareb More articles by this author Layane EL-Khoury More articles by this author Hani Tamim More articles by this author Viviane Chalhoub More articles by this author Albert EL Hajj More articles by this author Expand All Advertisement PDF downloadLoading ...