Academic Journal
Predictive value of the HAS-BLED score in the course of radical cystectomy: A pilot study.
| Τίτλος: | Predictive value of the HAS-BLED score in the course of radical cystectomy: A pilot study. |
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| Συγγραφείς: | Yorulmaz EM; Department of Urology, Izmir Katip Celebi University, Cigli, Turkey. Electronic address: enismertyorulmaz@yahoo.com., Akin Y; Department of Urology, Izmir Katip Celebi University, Cigli, Turkey., Donmez K; Department of Urology, Izmir Katip Celebi University, Cigli, Turkey., Gorgel SN; Department of Urology, Izmir Katip Celebi University, Cigli, Turkey., Ozcan S; Department of Urology, Izmir Katip Celebi University, Cigli, Turkey., Kose O; Department of Urology, Izmir Katip Celebi University, Cigli, Turkey., Gorgel A; Department of Endocrinology, Selcuk University, Selcuklu, Turkey., Sag B; Department of Endocrinology, Selcuk University, Selcuklu, Turkey. |
| Πηγή: | Urologic oncology [Urol Oncol] 2026 Jul; Vol. 44 (7), pp. 297-306. Date of Electronic Publication: 2026 Apr 30. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 9805460 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2496 (Electronic) Linking ISSN: 10781439 NLM ISO Abbreviation: Urol Oncol Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2003- : Philadelphia, PA : Elsevier Original Publication: New York, NY : Elsevier Science |
| Ιατρικοί όροι (MeSH): | Cystectomy*/adverse effects , Cystectomy*/methods , Urinary Bladder Neoplasms*/surgery , Postoperative Hemorrhage*/etiology , Postoperative Hemorrhage*/diagnosis , Blood Loss, Surgical*, Humans ; Female ; Male ; Retrospective Studies ; Pilot Projects ; Aged ; Predictive Value of Tests ; Middle Aged ; Risk Factors ; ROC Curve |
| Περίληψη: | Objective: To evaluate the predictive value of the preoperative HAS-BLED score in estimating clinically significant blood loss in the course of radical cystectomy. Materials and Methods: We retrospectively reviewed 176 patients who underwent radical cystectomy. Major hemorrhage was defined as a change in hemoglobin level (delta hemoglobin = preoperative hemoglobin level - postoperative hemoglobin level) of ≥4 g/dl, the need for blood transfusion to manage bleeding, or the necessity of early reintervention due to postoperative hemorrhage or related complications within 14 days. HAS-BLED scores were calculated preoperatively. Univariable and multivariable logistic regression analyses were performed to identify independent predictors. Receiver operating characteristic analysis was used to assess the discriminative ability of the HAS-BLED score. Results: Major postoperative bleeding occurred in 22 patients (12.5%). Bleeding patients had significantly higher HAS-BLED scores compared to those without bleeding (P < 0.001). Each 1-point increase in the HAS-BLED score tripled the odds of bleeding (odds ratio: 3.01, 95% confidence interval: 1.83-4.93). Multivariable analysis identified hypertension, renal or hepatic dysfunction, and a history of stroke as independent risk factors. Receiver operating characteristic analysis showed an area under the curve of 0.796, and the Youden-optimal cutoff was 2.5, corresponding to a clinical threshold of ≥3. In a subgroup of patients on anticoagulants (n = 35), 40% experienced bleeding, and HAS-BLED remained predictive (odds ratio: 2.02, P = 0.045). Conclusion: The HAS-BLED score effectively predicts clinically meaningful bleeding after radical cystectomy and may aid in preoperative risk stratification. A threshold of ≥3 appears suitable for identifying high-risk patients, particularly in those on anticoagulant therapy. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Complications; HAS-BLED score; Hemorrhage; Radical cystectomy; Risk factors |
| Entry Date(s): | Date Created: 20260501 Date Completed: 20260613 Latest Revision: 20260613 |
| Update Code: | 20260615 |
| DOI: | 10.1016/j.urolonc.2026.03.010 |
| PMID: | 42067425 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1873-2496 |
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| DOI: | 10.1016/j.urolonc.2026.03.010 |