Hollenbeck et al identified preoperative factors associated with complications following transurethral resection of a bladder tumor (TURBT). These can identify patients who may require closer monitoring and more aggressive management after surgery. The authors are from the University of Michigan, Veterans Affairs Medical Center Ann Arbor, and the National Surgical Quality Improvement Program.



(1) urinary tract infection

(2) hematuria

(3) short-term mortality (30 or 90 day)

(4) prolonged hospitalization

(5) other morbidities


Preoperative risk factors:

(1) disseminated urinary bladder cancer

(2) history of chronic obstructive pulmonary disease (COPD)

(3) unintended weight loss before surgery >= 10%

(4) preoperative acute renal failure

(5) preoperative serum albumin <= 3.5 g/dL

(6) dependent in functional status

(7) preoperative serum creatinine > 2 mg/dL (consistent with acute or chronic renal failure)

(8) preoperative bleeding disorder

(9) emergency surgery



• An additional risk factor was missing data on a history of radiotherapy in the 90 days before surgery. However, neither the presence or absence of recent radiotherapy had an effect, so I am not sure what "missing data" is really measuring.

• The odds ratios for complications with most factors was <= 2. The odds ratio was 4, so will be assigned 2 points in the implementation.


total number of risk factors =

= SUM(preoperative factors present)



• The risk of a postoperative complication increases as the number of risk factors increase.


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