McLaughlin et al identified risk factors affecting 30-day morbidity following urological surgery. These can help to identify patients with complications who may benefit from more aggressive management or alternative therapy. The authors are from the University of Michigan and are participants in the National Surgical Quality Improvement Program (NSQIP).


Adverse outcomes constituting morbidity: 46+ complications listed in the appendix (a slightly shorter list is given in Table 1)


Major risk factors for morbidity (odds ratio 12-14):

(1) diabetes with end-organ damage

(2) congestive heart failure


Additional risk factors (odds ratios 2-4):

(1) blood transfusion during surgery

(2) prolonged operative time

(3) low serum albumin (<= 3.5 g/dL)

(4) quadriplegia or quadriparesis

(5) history of angioplasty

(6) hydronephrosis



• The impact of diabetes without end-organ damage is less.

• Some risk factors are known before surgery and some after surgery. A preoperative assessment can identify most patients at risk for morbidity.


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