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A novel radical prostatectomy specific index (PSI) for the prediction of major cardiovascular events following surgery
Purpose Prostate cancer patients tend to be older with multiple comorbidities and are thus at increased risk for postoperative cardiovascular events after radical prostatectomy (RP). Thus, proper patient selection strategies are essential to decide for or against a surgical approach. We aimed to der...
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| Published in: | International urology and nephrology 2022-12, Vol.54 (12), p.3069-3078 |
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| Main Authors: | , , , , , , , |
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| cited_by | cdi_FETCH-LOGICAL-c352t-6742430263aac17a5c6190b44860cac0cf9cfca9550c7a56049453bcddb38a653 |
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| cites | cdi_FETCH-LOGICAL-c352t-6742430263aac17a5c6190b44860cac0cf9cfca9550c7a56049453bcddb38a653 |
| container_end_page | 3078 |
| container_issue | 12 |
| container_start_page | 3069 |
| container_title | International urology and nephrology |
| container_volume | 54 |
| creator | Ayoub, Christian H. El-Asmar, Jose M. Abou Heidar, Nassib F. Najm, Nicolas Nasrallah, Ali A. Tamim, Hani Dakik, Habib A. El Hajj, Albert |
| description | Purpose
Prostate cancer patients tend to be older with multiple comorbidities and are thus at increased risk for postoperative cardiovascular events after radical prostatectomy (RP). Thus, proper patient selection strategies are essential to decide for or against a surgical approach. We aimed to derive a prostatectomy specific index (PSI) for patients undergoing RP and compare its performance to universally used indices.
Methods
The cohort was derived from National Surgical Quality Improvement Program database between 2005 and 2012. The primary outcome was incidence of major adverse cardiovascular events at 30 days post-surgery including: death, myocardial infarction, or stroke. A multivariable logistic regression model was constructed, performance and calibration were evaluated using a ROC analysis and the Hosmer–Lemeshow test, the PSI index was derived and compared to the RCRI and AUB-HAS2 indices.
Results
A total of 17,299 patients were included in our cohort, with a mean age of 62 ± 7.4 years. Seventy three patients had a cardiac event post RP. The final PSI index encompassed six variables: history of heart disease, age, anemia, American society of anesthesiology class, surgical approach, and hypertension. The PSI ROC analysis provided C-statistic = 0.72, calibration
R
2
= 0.99 and proper goodness of fit. In comparison, the C-statistics of RCRI and AUB-HAS2 were found to be 0.57 and 0.65, respectively (
p
value |
| doi_str_mv | 10.1007/s11255-022-03293-3 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2704871351</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2704871351</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-6742430263aac17a5c6190b44860cac0cf9cfca9550c7a56049453bcddb38a653</originalsourceid><addsrcrecordid>eNp9kV1LwzAUhosoOKd_wKuAN_OiepI0_bgcw4_BQEG9DtlpOjPaZibtdP_ezAqKF14lJM_zkpM3is4pXFGA7NpTyoSIgbEYOCt4zA-iERUZj5nIk8Nf--PoxPs1ABQ5wCjaTklrt7omTpUGVU02zvpOdRo72-yI32g0lUFi2lJ_kMnj0_ySVNaR7lUHVAenM7YltiKNWodzVK40dqs89rVyRG912_lg1LV9N-2K-N6ttNudRkeVqr0--17H0cvtzfPsPl483M1n00WMXLAuTrOEJRxYypVCmimBKS1gmSR5CqgQsCqwQlUIARhuU0iKRPAlluWS5yoVfBxNhtww1luvfScb41HXtWq17b1kGSR5RrmgAb34g65t79rwukCxPBMphX0gGygM_-SdruTGmUa5naQg91XIoQoZqpBfVUgeJD5IPsBtmP8n-h_rEx9TjLY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2728756105</pqid></control><display><type>article</type><title>A novel radical prostatectomy specific index (PSI) for the prediction of major cardiovascular events following surgery</title><source>Springer Link</source><creator>Ayoub, Christian H. ; El-Asmar, Jose M. ; Abou Heidar, Nassib F. ; Najm, Nicolas ; Nasrallah, Ali A. ; Tamim, Hani ; Dakik, Habib A. ; El Hajj, Albert</creator><creatorcontrib>Ayoub, Christian H. ; El-Asmar, Jose M. ; Abou Heidar, Nassib F. ; Najm, Nicolas ; Nasrallah, Ali A. ; Tamim, Hani ; Dakik, Habib A. ; El Hajj, Albert</creatorcontrib><description>Purpose
Prostate cancer patients tend to be older with multiple comorbidities and are thus at increased risk for postoperative cardiovascular events after radical prostatectomy (RP). Thus, proper patient selection strategies are essential to decide for or against a surgical approach. We aimed to derive a prostatectomy specific index (PSI) for patients undergoing RP and compare its performance to universally used indices.
Methods
The cohort was derived from National Surgical Quality Improvement Program database between 2005 and 2012. The primary outcome was incidence of major adverse cardiovascular events at 30 days post-surgery including: death, myocardial infarction, or stroke. A multivariable logistic regression model was constructed, performance and calibration were evaluated using a ROC analysis and the Hosmer–Lemeshow test, the PSI index was derived and compared to the RCRI and AUB-HAS2 indices.
Results
A total of 17,299 patients were included in our cohort, with a mean age of 62 ± 7.4 years. Seventy three patients had a cardiac event post RP. The final PSI index encompassed six variables: history of heart disease, age, anemia, American society of anesthesiology class, surgical approach, and hypertension. The PSI ROC analysis provided C-statistic = 0.72, calibration
R
2
= 0.99 and proper goodness of fit. In comparison, the C-statistics of RCRI and AUB-HAS2 were found to be 0.57 and 0.65, respectively (
p
value < 0.001).
Conclusion
The PSI model is a procedure tailored index for prediction of major cardiovascular events post RP. It was calibrated using a large national database aiming to optimize treatment selection strategies for prostate cancer patients.</description><identifier>ISSN: 1573-2584</identifier><identifier>ISSN: 0301-1623</identifier><identifier>EISSN: 1573-2584</identifier><identifier>DOI: 10.1007/s11255-022-03293-3</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Cancer surgery ; Cardiovascular diseases ; Cerebral infarction ; Comorbidity ; Coronary artery disease ; Heart diseases ; Medicine ; Medicine & Public Health ; Myocardial infarction ; Nephrology ; Patients ; Prostate cancer ; Prostatectomy ; Quality control ; Statistical analysis ; Surgery ; Urological surgery ; Urology ; Urology - Original Paper</subject><ispartof>International urology and nephrology, 2022-12, Vol.54 (12), p.3069-3078</ispartof><rights>The Author(s), under exclusive licence to Springer Nature B.V. 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-6742430263aac17a5c6190b44860cac0cf9cfca9550c7a56049453bcddb38a653</citedby><cites>FETCH-LOGICAL-c352t-6742430263aac17a5c6190b44860cac0cf9cfca9550c7a56049453bcddb38a653</cites><orcidid>0000-0002-6947-7937 ; 0000-0002-0043-7195 ; 0000-0003-2475-4256 ; 0000-0003-3811-5543 ; 0000-0001-7086-1410 ; 0000-0001-6436-600X ; 0000-0001-7749-1045 ; 0000-0002-9500-7840</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Ayoub, Christian H.</creatorcontrib><creatorcontrib>El-Asmar, Jose M.</creatorcontrib><creatorcontrib>Abou Heidar, Nassib F.</creatorcontrib><creatorcontrib>Najm, Nicolas</creatorcontrib><creatorcontrib>Nasrallah, Ali A.</creatorcontrib><creatorcontrib>Tamim, Hani</creatorcontrib><creatorcontrib>Dakik, Habib A.</creatorcontrib><creatorcontrib>El Hajj, Albert</creatorcontrib><title>A novel radical prostatectomy specific index (PSI) for the prediction of major cardiovascular events following surgery</title><title>International urology and nephrology</title><addtitle>Int Urol Nephrol</addtitle><description>Purpose
Prostate cancer patients tend to be older with multiple comorbidities and are thus at increased risk for postoperative cardiovascular events after radical prostatectomy (RP). Thus, proper patient selection strategies are essential to decide for or against a surgical approach. We aimed to derive a prostatectomy specific index (PSI) for patients undergoing RP and compare its performance to universally used indices.
Methods
The cohort was derived from National Surgical Quality Improvement Program database between 2005 and 2012. The primary outcome was incidence of major adverse cardiovascular events at 30 days post-surgery including: death, myocardial infarction, or stroke. A multivariable logistic regression model was constructed, performance and calibration were evaluated using a ROC analysis and the Hosmer–Lemeshow test, the PSI index was derived and compared to the RCRI and AUB-HAS2 indices.
Results
A total of 17,299 patients were included in our cohort, with a mean age of 62 ± 7.4 years. Seventy three patients had a cardiac event post RP. The final PSI index encompassed six variables: history of heart disease, age, anemia, American society of anesthesiology class, surgical approach, and hypertension. The PSI ROC analysis provided C-statistic = 0.72, calibration
R
2
= 0.99 and proper goodness of fit. In comparison, the C-statistics of RCRI and AUB-HAS2 were found to be 0.57 and 0.65, respectively (
p
value < 0.001).
Conclusion
The PSI model is a procedure tailored index for prediction of major cardiovascular events post RP. It was calibrated using a large national database aiming to optimize treatment selection strategies for prostate cancer patients.</description><subject>Cancer surgery</subject><subject>Cardiovascular diseases</subject><subject>Cerebral infarction</subject><subject>Comorbidity</subject><subject>Coronary artery disease</subject><subject>Heart diseases</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Myocardial infarction</subject><subject>Nephrology</subject><subject>Patients</subject><subject>Prostate cancer</subject><subject>Prostatectomy</subject><subject>Quality control</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Urological surgery</subject><subject>Urology</subject><subject>Urology - Original Paper</subject><issn>1573-2584</issn><issn>0301-1623</issn><issn>1573-2584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kV1LwzAUhosoOKd_wKuAN_OiepI0_bgcw4_BQEG9DtlpOjPaZibtdP_ezAqKF14lJM_zkpM3is4pXFGA7NpTyoSIgbEYOCt4zA-iERUZj5nIk8Nf--PoxPs1ABQ5wCjaTklrt7omTpUGVU02zvpOdRo72-yI32g0lUFi2lJ_kMnj0_ySVNaR7lUHVAenM7YltiKNWodzVK40dqs89rVyRG912_lg1LV9N-2K-N6ttNudRkeVqr0--17H0cvtzfPsPl483M1n00WMXLAuTrOEJRxYypVCmimBKS1gmSR5CqgQsCqwQlUIARhuU0iKRPAlluWS5yoVfBxNhtww1luvfScb41HXtWq17b1kGSR5RrmgAb34g65t79rwukCxPBMphX0gGygM_-SdruTGmUa5naQg91XIoQoZqpBfVUgeJD5IPsBtmP8n-h_rEx9TjLY</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Ayoub, Christian H.</creator><creator>El-Asmar, Jose M.</creator><creator>Abou Heidar, Nassib F.</creator><creator>Najm, Nicolas</creator><creator>Nasrallah, Ali A.</creator><creator>Tamim, Hani</creator><creator>Dakik, Habib A.</creator><creator>El Hajj, Albert</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6947-7937</orcidid><orcidid>https://orcid.org/0000-0002-0043-7195</orcidid><orcidid>https://orcid.org/0000-0003-2475-4256</orcidid><orcidid>https://orcid.org/0000-0003-3811-5543</orcidid><orcidid>https://orcid.org/0000-0001-7086-1410</orcidid><orcidid>https://orcid.org/0000-0001-6436-600X</orcidid><orcidid>https://orcid.org/0000-0001-7749-1045</orcidid><orcidid>https://orcid.org/0000-0002-9500-7840</orcidid></search><sort><creationdate>20221201</creationdate><title>A novel radical prostatectomy specific index (PSI) for the prediction of major cardiovascular events following surgery</title><author>Ayoub, Christian H. ; El-Asmar, Jose M. ; Abou Heidar, Nassib F. ; Najm, Nicolas ; Nasrallah, Ali A. ; Tamim, Hani ; Dakik, Habib A. ; El Hajj, Albert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-6742430263aac17a5c6190b44860cac0cf9cfca9550c7a56049453bcddb38a653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cancer surgery</topic><topic>Cardiovascular diseases</topic><topic>Cerebral infarction</topic><topic>Comorbidity</topic><topic>Coronary artery disease</topic><topic>Heart diseases</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Myocardial infarction</topic><topic>Nephrology</topic><topic>Patients</topic><topic>Prostate cancer</topic><topic>Prostatectomy</topic><topic>Quality control</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Urological surgery</topic><topic>Urology</topic><topic>Urology - Original Paper</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ayoub, Christian H.</creatorcontrib><creatorcontrib>El-Asmar, Jose M.</creatorcontrib><creatorcontrib>Abou Heidar, Nassib F.</creatorcontrib><creatorcontrib>Najm, Nicolas</creatorcontrib><creatorcontrib>Nasrallah, Ali A.</creatorcontrib><creatorcontrib>Tamim, Hani</creatorcontrib><creatorcontrib>Dakik, Habib A.</creatorcontrib><creatorcontrib>El Hajj, Albert</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International urology and nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ayoub, Christian H.</au><au>El-Asmar, Jose M.</au><au>Abou Heidar, Nassib F.</au><au>Najm, Nicolas</au><au>Nasrallah, Ali A.</au><au>Tamim, Hani</au><au>Dakik, Habib A.</au><au>El Hajj, Albert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A novel radical prostatectomy specific index (PSI) for the prediction of major cardiovascular events following surgery</atitle><jtitle>International urology and nephrology</jtitle><stitle>Int Urol Nephrol</stitle><date>2022-12-01</date><risdate>2022</risdate><volume>54</volume><issue>12</issue><spage>3069</spage><epage>3078</epage><pages>3069-3078</pages><issn>1573-2584</issn><issn>0301-1623</issn><eissn>1573-2584</eissn><abstract>Purpose
Prostate cancer patients tend to be older with multiple comorbidities and are thus at increased risk for postoperative cardiovascular events after radical prostatectomy (RP). Thus, proper patient selection strategies are essential to decide for or against a surgical approach. We aimed to derive a prostatectomy specific index (PSI) for patients undergoing RP and compare its performance to universally used indices.
Methods
The cohort was derived from National Surgical Quality Improvement Program database between 2005 and 2012. The primary outcome was incidence of major adverse cardiovascular events at 30 days post-surgery including: death, myocardial infarction, or stroke. A multivariable logistic regression model was constructed, performance and calibration were evaluated using a ROC analysis and the Hosmer–Lemeshow test, the PSI index was derived and compared to the RCRI and AUB-HAS2 indices.
Results
A total of 17,299 patients were included in our cohort, with a mean age of 62 ± 7.4 years. Seventy three patients had a cardiac event post RP. The final PSI index encompassed six variables: history of heart disease, age, anemia, American society of anesthesiology class, surgical approach, and hypertension. The PSI ROC analysis provided C-statistic = 0.72, calibration
R
2
= 0.99 and proper goodness of fit. In comparison, the C-statistics of RCRI and AUB-HAS2 were found to be 0.57 and 0.65, respectively (
p
value < 0.001).
Conclusion
The PSI model is a procedure tailored index for prediction of major cardiovascular events post RP. It was calibrated using a large national database aiming to optimize treatment selection strategies for prostate cancer patients.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><doi>10.1007/s11255-022-03293-3</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-6947-7937</orcidid><orcidid>https://orcid.org/0000-0002-0043-7195</orcidid><orcidid>https://orcid.org/0000-0003-2475-4256</orcidid><orcidid>https://orcid.org/0000-0003-3811-5543</orcidid><orcidid>https://orcid.org/0000-0001-7086-1410</orcidid><orcidid>https://orcid.org/0000-0001-6436-600X</orcidid><orcidid>https://orcid.org/0000-0001-7749-1045</orcidid><orcidid>https://orcid.org/0000-0002-9500-7840</orcidid></addata></record> |
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| subjects | Cancer surgery Cardiovascular diseases Cerebral infarction Comorbidity Coronary artery disease Heart diseases Medicine Medicine & Public Health Myocardial infarction Nephrology Patients Prostate cancer Prostatectomy Quality control Statistical analysis Surgery Urological surgery Urology Urology - Original Paper |
| title | A novel radical prostatectomy specific index (PSI) for the prediction of major cardiovascular events following surgery |
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