Prospective and multicenter validation of the BETTY score for predicting perioperative outcomes after elective urological surgery

Postoperative complications remain a significant challenge in surgical care. This study assessed the ability of the BETTY score, a novel user-friendly scoring system, to predict postoperative outcomes in a large multicenter cohort of urological surgeries. We conducted a post-hoc analysis of a prospective, nonrandomized multicenter trial including 415 patients undergoing elective urological surgeries in six French hospitals. The BETTY score, part of a smartphone app, incorporates pre- and intraoperative data to classify patients into risk categories. We evaluated multiple endpoints, including 90-day postoperative overall and major complications, length of stay, prolonged care after discharge, unplanned readmission, reoperation, and days alive and out of hospital. Of the 415 patients, 22% experienced postoperative complications, with 3.9% major complications. Unplanned readmissions, prolonged care after discharge, and reoperation occurred in 8%, 20%, and 2.4% of cases, respectively. We found significant correlations between the BETTY score and all endpoints analyzed. In multivariate analysis, the BETTY score was significantly associated with all postoperative events studied. These findings demonstrate the reliability of the BETTY score in predicting various postoperative outcomes in urological surgery patients, especially for patients undergoing major surgeries. This tool may help optimize perioperative care and improve patient outcomes, potentially contributing to more personalized surgical care.