Value of Flemish Version of the Triage Risk Screening Tool in Predicting Unfavorable Outcomes after Elective Cancer Surgery: A Propensity Score-Matched Retrospective Cohort Study.

INTRODUCTION

The Flemish version of the Triage Risk Screening Tool (fTRST), derived from the Triage Risk Screening Tool for assessing risk of readmission to the emergency department, is increasingly used as a simple screening tool in oncology. This study aimed to evaluate the utility of the fTRST in the context of elective surgical treatment for urologic cancer patients.

METHODS

We included 886 patients who underwent major urologic cancer surgery at our institution between 2020 and 2022 and underwent preoperative screening, including fTRST. We set the fTRST cutoff at 2 and used propensity score matching and multivariate regression analysis to assess how fTRST affected two postoperative outcomes: ambulation failure and delirium.

RESULTS

Of the 886 patients, 693 (78%) had an fTRST score <2, and 193 (22%) had an fTRST score ≥2 (high likelihood of frailty). After matching the groups by propensity scores, we compared the outcomes of 131 patients in each group. We found that the group with fTRST ≥2 had significantly higher rates of ambulation failure (15 vs. 11%, p = 0.03) and delirium (16 vs. 11%, p = 0.008) than the group with fTRST <2. Multivariate logistic regression analysis showed that fTRST score ≥2 was an independent risk factor for postoperative ambulation failure (odds ratio [OR] = 4.05, p = 0.02), along with age ≥75 years (OR = 6.62, p = 0.02), preoperative benzodiazepine medications (OR = 5.12, p = 0.01), and receiving radical cystectomy (OR = 9.30, p = 0.02). Similarly, for delirium, fTRST score ≥2 was an independent risk factor (OR = 2.88, p = 0.03), along with preoperative benzodiazepine medications (OR = 4.38, p = 0.002).

CONCLUSION

The fTRST might be a screening tool with great potential for identifying patients at high risk for unfavorable postoperative outcomes in elective urologic cancer surgery.