Prediction Score For Perioperative Complications Of Transurethral Prostatectomy (Turp)

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology (II)1 Apr 20131988 PREDICTION SCORE FOR PERIOPERATIVE COMPLICATIONS OF TRANSURETHRAL PROSTATECTOMY (TURP) Dan Leibovici, Ilia Beberashvili, Yaniv Shilo, Shmuel Roizman, Amir Cooper, Avraham Chachashvili, Arie Lindner, Amnon Zisman, Yoram Siegel, and Kobi Stav Dan LeiboviciDan Leibovici Zerifin, Israel More articles by this author , Ilia BeberashviliIlia Beberashvili Zerifin, Israel More articles by this author , Yaniv ShiloYaniv Shilo Zerifin, Israel More articles by this author , Shmuel RoizmanShmuel Roizman Zerifin, Israel More articles by this author , Amir CooperAmir Cooper Zerifin, Israel More articles by this author , Avraham ChachashviliAvraham Chachashvili Zerifin, Israel More articles by this author , Arie LindnerArie Lindner Zerifin, Israel More articles by this author , Amnon ZismanAmnon Zisman Zerifin, Israel More articles by this author , Yoram SiegelYoram Siegel Zerifin, Israel More articles by this author , and Kobi StavKobi Stav Zerifin, Israel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2407AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Predicting TURP complications may improve patient selection and outcome. To date no prediction tools for postoperative complications of TURP have been developed. METHODS data were retrospectively collected on 337 consecutive patients who had undergone monopolar TURP at our center. These included: age, resected prostate weight, indwelling catheter, Charlson co-morbidity score, oral anticoagulants, and surgeon identity. Perioperative complications were graded according to Clavien's grades. Univariate analysis and multivariate logistic regressions were used to detect predictors of severe (Clavien≥3b) complications, or bleeding requiring 2 or more blood transfusions. Receiver-operator curve analyses provided best cutoff values. Further multivariate analysis using these cutoffs provided odds ratios (OR) and β coefficients for each predictor. The weight of each predictor was calculated by multiplying the β coefficient and rounding the result up to the next integer. Possible prediction scores were generated by various predictor combinations. The selected score was the one that rendered the highest OR. RESULTS Complications occurred in 104 (30.8%) patients. Bleeding was the most common complication (n=42; 12.4%). Severe complications (Clavien grade≥3b) occurred in 15 (4.5%) patients and 2 patients died (0.59%). The following predictor combination provided the highest OR for bleeding or severe complications: age, indwelling catheter, resected prostate weight and anticoagulation OR=17.83 (95% CI 7.178-44.288). Cutoff value and β calculations allowed for the following prediction score construction: Table 1 Univariate analysis and multivariate logistic regression for the risk of bleeding and severe complications for 4 score ranges provided the following ORs: Table 2 CONCLUSIONS A simple and powerful prediction score for TURP complications is provided. Table 1. prediction score Predictor Value Points Yes No Age (years) > 73 1.5 0 Prostate weight (gr) < 27 0 27.0-39.9 3.5 40-51.9 5.5 52-64 7.0 > 64 8.0 Indwelling catheter 1.5 0 Anticoagulants 1.5 0 Totals 0-12.5 Table 2. univariate & multivariate analyses for bleeding and severe complications at various score ranges Variable Univariate Multivariate OR (95%CI) p OR (95%CI) p Bleeding Score 0-3.5 Reference Reference 4.0-6.0 5.120 (1.614-16.240) 0.006 5.406 (1.675-17.446) 0.005 6.5-8.5 20.400 (7.032-59.180) 0.0001 20.562 (6.945-60.873) 0.0001 9.0-12.5 46.080 (13.581-156.348) 0.0001 48.806 (13.630-174.768) 0.0001 Severe (Clavien ≥3b) complications Score 0-3.5 Reference Reference 4.0-6.0 12.250 (1.345-111.600) 0.007 11.477 (1.361-114.355) 0.026 6.5-8.5 17.422 (1.901-159.632) 0.001 17.667 (1.910-163.428) 0.011 9.0-12.5 57.647 (6.365-522.078) 0.0001 63.498 (6.621-609.001) 0.0001 © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e816 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dan Leibovici Zerifin, Israel More articles by this author Ilia Beberashvili Zerifin, Israel More articles by this author Yaniv Shilo Zerifin, Israel More articles by this author Shmuel Roizman Zerifin, Israel More articles by this author Amir Cooper Zerifin, Israel More articles by this author Avraham Chachashvili Zerifin, Israel More articles by this author Arie Lindner Zerifin, Israel More articles by this author Amnon Zisman Zerifin, Israel More articles by this author Yoram Siegel Zerifin, Israel More articles by this author Kobi Stav Zerifin, Israel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...