Impact of physiological ability and surgical stress score on postoperative complications in patients undergoing surgery for non-muscle-invasive bladder cancer

This study aims to evaluate the predictive value of the physiological ability and surgical stress (E-PASS) scoring system for postoperative complications in patients undergoing surgery for non-muscle-invasive bladder cancer (NMIBC). This retrospective study included patients with NMIBC who underwent transurethral resection of bladder tumor. The E-PASS score was calculated for each patient. Postoperative in-hospital complications were recorded and graded according to the Clavien-Dindo classification. Logistic regression analysis was used to identify independent risk factors, and receiver operating characteristic curves were constructed to assess predictive performance. Significant differences were observed between the two groups in intraoperative blood loss, tumor differentiation grade, and the E-PASS scores (all P < .05). Multivariate analysis identified poor differentiation grade (odds ratio [OR] = 1.625), greater intraoperative blood loss (OR = 1.239), preoperative risk score (OR = 1.442), surgical stress score (OR = 1.376), and comprehensive risk score (CRS; OR = 1.272) as independent risk factors for in-hospital complications (all P < .05). Receiver operating characteristic analysis demonstrated high predictive accuracy for the E-PASS components: the area under the curve was 0.926 for preoperative risk score (sensitivity 85.71%, specificity 85.77%), 0.915 for surgical stress score (sensitivity 71.43%, specificity 89.29%), and 0.942 for CRS (sensitivity 78.57%, specificity 89.29%). Furthermore, at 24 and 36 months post-surgery, the recurrence rate was significantly lower in the non-complication group compared to the complication group (P < .05). The E-PASS scoring system, particularly the CRS, is a useful tool for predicting postoperative complications in patients undergoing surgery for NMIBC.