Association of metabolic equivalent of task (MET) score in length of stay in hospital following radical cystectomy with urinary diversion:a multi-institutional study

PURPOSE: The Metabolic equivalent of task (MET) score is used in patients’ preoperative functional capacity assessment. It is commonly thought that patients with a higher MET score will have better postoperative outcomes than patients with a lower MET score. However, such a link remains the subject of debate and is yet unvalidated in major urological surgery. This study aimed to explore the association of patients’ MET score with their postoperative outcomes following radical cystectomy. METHODS: We used records-linkage methodology with unique identifiers (Community Health Index/hospital number) and electronic databases to assess postoperative outcomes of patients who had underwent radical cystectomies between 2015 and 2020. The outcome measure was patients’ length of hospital stay. This was compared with multiple basic characteristics such as age, sex, MET score and comorbid conditions. A MET score of less than four (< 4) is taken as the threshold for a poor functional capacity. We conducted unadjusted and adjusted Cox regression analyses for time to discharge against MET score. RESULTS: A total of 126 patients were included in the analysis. Mean age on date of operation was 66.2 (SD 12.2) years and 49 (38.9%) were female. A lower MET score was associated with a statistically significant lower time-dependent risk of hospital discharge (i.e. longer hospital stay) when adjusted for covariates (HR 0.224; 95% CI 0.077–0.652; p = 0.006). Older age (adjusted HR 0.531; 95% CI 0.332–0.848; p = 0.008) and postoperative complications (adjusted HR 0.503; 95% CI 0.323–0.848; p = 0.002) were also found to be associated with longer hospital stay. Other comorbid conditions, BMI, disease staging and 30-day all-cause mortality were statistically insignificant. CONCLUSION: A lower MET score in this cohort of patients was associated with a longer hospital stay length following radical cystectomy with urinary diversion. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11255-021-02813-x

Short- and long-term mortality in patients with ST-elevation myocardial infarction treated with primary angioplasty: predictive value of four different risk scoring systems

Predictive value of different risk scoring systems for short-term mortality in a population of patients with ST-elevation myocardial infarction treated with primary angioplast

Feasibility, Safety and Hemodinamic Changes With a New Ventricular Assist Device During High Risk Percutaneous Coronary Interventions

Feasibility, Safety and Hemodinamic Changes With a New Ventricular Assist Device During High Risk Percutaneous Coronary Intervention

Sex differences in noninvasive diagnosis of multivessel coronary artery disease

ABSTRACT OF THE ANNUAL CONGRESS OF THE AMERICAN COLLEGE OF CARDIOLOG

Left atrial size is the major predictor of cardiac death and overall clinical outcome in patients with dilated cardiomyopathy: A long-term follow-up study

Hypothesis: This study was undertaken to determine whether echo-derived left atrial dimension and other echocardiographic, clinical, and hemodynamic parameters detected at the time of entry into the study may influence prognosis in patients with dilated cardiomyopathy during a long-term follow-up. Methods: This was a prospective cohort analysis of 123 patients with dilated cardiomyopathy. Clinical evaluation, chest x-ray, M-mode and two-dimensional echocardiogram, exercise test, 72-h ambulatory electrocardiogram monitoring, and cardiac catheterization study were performed in all patients. The study was divided into two phases: in the first phase, patients were divided into two groups according to the left atrial size (greater than or equal to 45 mm; 17 mmKg, and exercise tolerance less than or equal to 15 min were independent predictors of poor clinical outcome. Conclusions: Our results revealed that left atrial size is the principal independent predictor of prognosis in patients with dilated cardiomyopathy in that patients with left atrial dilation had an increase in mortality and a worse clinical outcome compared with those without left atrial dilation

Early aggressive versus conservative managment on one year outcome in octogenarians patients with unstable angina and non-st-elevation myocardial infarction

Early aggressive versus conservative managment on one year outcome in octogenarians patients with unstable angina and non-st-elevation myocardial infarctio