• Michael Froehner, Rainer Koch, Matthias Hübler, Ulrike Heberling, Vladimir Novotny, Stefan Zastrow, and Manfred P Wirth.
• Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. Electronic address: Michael.Froehner@uniklinikum-dresden.de.
• Eur Urol Focus. 2019 Mar 1; 5 (2): 197-200.

Standardized prediction of perioperative mortality risk is of major clinical concern in the radical cystectomy setting. We validated the recently developed Preoperative Score to Predict Postoperative Mortality (POSPOM) in a sample of 1083 consecutive cystectomy patients treated between 1993 and 2014. POSPOM was calculated as originally described based on age and 13 further parameters; three parameters which were not available in our database were ignored. Thirty-day and 90-d mortality were 1.0% and 4.1%, respectively. The areas under the receiver operator characteristic curves were 0.86 for 30-d mortality and 0.78 for 90-d mortality. Below the median of 27 POSPOM risk points, 30-d mortality was 0% and 90-d mortality was 0.5%. Above this level, the corresponding figures were 1.7% and 6.5%, respectively. The 30-d (p<0.0001) and even the 90-d mortality rates (p=0.004) were lower than the POSPOM-predicted in-hospital mortality rate for this sample (5.8%). Nevertheless, with its good discriminative accuracy, POSPOM might standardize the prediction of postoperative mortality after radical cystectomy. The absolute mortality figures in a high volume academic center were, however, lower than predicted based on nationwide collected data. PATIENT SummaryWith a good discriminative accuracy, Preoperative Score to Predict Postoperative Mortality might standardize the prediction of postoperative mortality after radical cystectomy. The absolute mortality figures in a high volume academic center were, however, lower than predicted based on nationwide collected data.Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

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