PD60-07 OBJECTIVE RISK SCORE RELIABLY PREDICTS MAJOR MORBIDITY AND MORTALITY AFTER RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyCME1 May 2022PD60-07 OBJECTIVE RISK SCORE RELIABLY PREDICTS MAJOR MORBIDITY AND MORTALITY AFTER RADICAL PROSTATECTOMY Kristen Maatman, Christopher Ledbetter, A. Lynn Patterson, and Robert Wake Kristen MaatmanKristen Maatman More articles by this author , Christopher LedbetterChristopher Ledbetter More articles by this author , A. Lynn PattersonA. Lynn Patterson More articles by this author , and Robert WakeRobert Wake More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002645.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical prostatectomy (RP) is the gold-standard treatment for localized prostate cancer. We have previously developed and validated a 30-day mortality risk score after radical cystectomy and radical nephrectomy and hypothesized that this risk score could be applied to patients undergoing RP for prostate cancer. METHODS: The National Surgical Quality Improvement Program (NSQIP) identified 48,285 patients that underwent RP for malignancy from 2014-2018. Only patients with complete data for risk score calculation were included in this analysis. Risk factors for 30-day mortality were identified on multivariable analysis using backward stepwise binary logistic regression. A previously developed and validated mortality risk score (Figure 1A) was calculated for each patient undergoing RP. A receiver operating characteristic (ROC) curve was created to quantify the discriminatory ability of the risk calculator. P values <0.05 were accepted as statistically significant. The primary aim of this study was to stratify the risk of 30-day mortality after RP; secondary aims included risk stratification of major morbidity and all-cause morbidity. RESULTS: 17,699 RP patients were included. Most underwent robotic assisted laparoscopic prostatectomy (89%, n=15,695). Mean age was 62±7 years. Rates of 30-day major morbidity and all-cause morbidity were 6.0% and 10.6%, respectively. Postoperative 30-day mortality was 0.19% (n=34). Multivariable analysis associated chronic obstructive pulmonary disorder, lower albumin and hematocrit, and elevated alkaline phosphatase with 30-day mortality (p <0.05). After RP 30-day mortality increased exponentially with escalating risk category (Figure 1B). The area under the ROC curve for the mortality risk score in patients that underwent RP was 0.702 (95% CI, 0.609-0.796; p <0.0001). The risk score additionally stratified the risk of 30-day major morbidity (AUC, 0.867; 95% CI, 0.788-0.947; p <0.0001) and all-cause morbidity (AUC, 0.860; 95% CI, 0.785-0.934; p <0.0001) after RP (Figure 1C). CONCLUSIONS: A previously established mortality risk score can be employed in patients undergoing RP for prostate cancer to stratify 30-day mortality risk as well as risk of major morbidity. This risk score is reliable, accurate, and applicable to both minimally invasive and open RP. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e1027 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kristen Maatman More articles by this author Christopher Ledbetter More articles by this author A. Lynn Patterson More articles by this author Robert Wake More articles by this author Expand All Advertisement PDF DownloadLoading ...