National Surgical Quality Improvement Program Surgical Risk Calculator Poorly Predicts Complications in Patients Undergoing Radical Cystectomy with Urinary Diversion: The Case for a Procedure-Specific Risk Calculator

    April 2017 in “ ˜The œJournal of urology/˜The œjournal of urology ”
    Melanie Adamsky, Shay Golan, Chuanhong Liao, Scott Johnson, Nimrod Barashi, Raj Bhanvadia, Norm D. Smith, Gary D. Steinberg, Arieh L. Shalhav
    TLDR Finasteride use is linked to a lower risk of bladder cancer, especially in Caucasians and Hispanics.
    The study evaluated the accuracy of the NSQIP surgical risk calculator for predicting complications in 567 patients undergoing radical cystectomy with urinary diversion. The results showed that the calculator poorly predicted most postoperative complications, including serious complications, surgical site infections, and urinary tract infections, with Brier scores exceeding the acceptable threshold of 0.01. The risk of serious complications and length of stay were significantly underestimated. However, the calculator adequately predicted the risk of death for patients receiving orthotopic neobladder diversion. The findings suggested the need for a procedure-specific risk calculator to improve preoperative counseling and quality measures.
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