Accuracy of American College of Surgeons National Surgical Quality Improvement Program Universal Surgical Risk Calculator in Predicting Complications Following Robot-Assisted Radical Cystectomy at a National Comprehensive Cancer Center

Lone, Zaeem; Hall, Shelby; Taguchi, Tomoaki; Ahmed, Youssef; Elsayed, Ahmed S.; Aldhaam, Naif A.; May, Paul; Miller, Austin; Jing, Zhe; Bragayrac, Luciano Nunez; Khan, Hassan A.; Cohen, Jared; Cole, Adam; Rana, Omer; Kanapan, Renuka; Prechtl, Christian; Hussein, Ahmed A.

doi:10.1089/end.2019.0093

Cited by 19 publications

(14 citation statements)

References 17 publications

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“…Despite limiting data regarding esophagogastric patients, the ACS NSQIP risk calculator was evaluated for a broad range of various study populations, ranging from head and neck cancer patients [21] to patients who underwent cystectomy [22]. Results of these studies were ambiguous: while the risk score demonstrated low accuracy in predicting postoperative outcomes in some cohorts [22,23], it was considered as a reliable tool in the prediction of prognosis in other study populations [21,24], suggesting that further studies are needed for validation. Furthermore, we analyzed prediction models that were developed for esophagogastric surgery such as the Cologne Risk score.…”

Section: Discussionmentioning

confidence: 99%

Impact of preoperative risk factors on outcome after gastrectomy

et al. 2020

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Background: Gastrectomy is associated with relevant postoperative morbidity. However, outcome of surgery can be improved by careful selection of patients. The objective of the current study was therefore to identify preoperative risk factors that might impact on patients' further outcome after surgical resection. Methods: Preoperative risk factors having respectively different surgical risk scores for major complex surgery (including Cologne Risk Score, p-/o-POSSUM, and NSQIP risk score) of patients that underwent gastrectomy for AEG II/III tumors and gastric cancer were correlated with complications according to Clavien-Dindo and outcome. Patients who underwent surgery in palliative intention were excluded from further analysis. Results: Subtotal gastrectomy was performed in 23%, gastrectomy in 59%, and extended gastrectomy in 18% in a total of 139 patients (mean age: 64 years old). Thirty six percent experienced a minor complication (Dindo I-II) and 24% a major complication (Dindo III-V), which resulted in a prolonged hospital stay (p < 0.001). In-hospital mortality (=Dindo V) was 2.5%. Besides age, type of surgical procedure impacted on complications with extended gastrectomy showing the highest risk (p = 0.005). The o-POSSUM score failed to predict mortality accurately. We observed a highly positive correlation between predicted morbidity respectively mortality and occurrence of complications estimated by p-POSSUM (p = 0.005), Cologne Risk (p = 0.007), and NSQIP scores (p < 0.001). Conclusion: The results demonstrate a significant association between different risk scores and occurrence of complications following gastrectomy. The p-POSSUM, Cologne Risk, and NSQIP score exhibited superior performance than the o-POSSUM score. Therefore, these scores might allow identification and selection of high-risk patients and thus might be highly useful for clinical decision making.

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Section: Discussionmentioning

confidence: 99%

Impact of preoperative risk factors on outcome after gastrectomy

et al. 2020

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“…A comprehensive preoperative evaluation of the patient’s medical conditions, including detailed medical and surgical history, and comprehensive assessment, are mandatory. Addressing the modifiable risk factors is crucial by encouraging breathing exercises, smoking cessation, diet counseling and nutritional supplementation for malnourished individuals . Comprehensive preoperative counseling has been shown to motivate patients, improve recovery and reduce complications .…”

Section: Techniquementioning

confidence: 99%

“…The NSQIP database was developed to improve the quality of surgical care through reducing complications and costs. A study was carried out to evaluate the accuracy of the NSQIP for RARC patients, which has shown poor performance, highlighting the need for more specific tools …”

Section: Techniquementioning

confidence: 99%

“…Addressing the modifiable risk factors is crucial by encouraging breathing exercises, smoking cessation, diet counseling and nutritional supplementation for malnourished individuals. [9][10][11] Comprehensive preoperative counseling has been shown to motivate patients, improve recovery and reduce complications. 12 The Enhanced Recovery After Surgery protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the stress response after surgery.…”

Section: Technique Preoperative Preparationmentioning

confidence: 99%

“…A study was carried out to evaluate the accuracy of the NSQIP for RARC patients, which has shown poor performance, highlighting the need for more specific tools. 10…”

Section: Technique Preoperative Preparationmentioning

confidence: 99%

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Robot‐assisted radical cystectomy: Review of surgical technique, and perioperative, oncological and functional outcomes

et al. 2020

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Since the introduction of robot‐assisted radical cystectomy, efforts have been made to meet the standards in terms of perioperative safety and oncological efficacy. Several randomized controlled studies and meta‐analyses, and multi‐institutional studies have shown comparable outcomes of robot‐assisted radical cystectomy when compared with the conventional open approach. In this review, we aimed to describe the surgical technique of robot‐assisted radical cystectomy and urinary diversion, and perioperative, pathological, oncological and functional outcomes.

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