The BETTY Score to Predict Perioperative Outcomes in Surgical Patients

SIMPLE SUMMARY: Careful monitoring and analysis of surgical outcomes is crucial for ensuring the safety and quality of clinical care. Therefore, a simple and low-cost metric of the risk of postoperative adverse events that would provide timely feedback to surgical teams in any setting is needed. However, current models primarily include anesthetic data that are not readily available to surgeons, and their ability to predict surgical outcomes has been often questioned. Here, we proposed a new user-friendly scoring system, namely the BETTY score and found that it was strongly associated with postoperative morbidity after radical prostatectomy. Future studies, in various surgical subspecialties, are ongoing to confirm the usefulness of this easy-to-use score in routine. ABSTRACT: The aim of this study is to evaluate a new user-friendly scoring system, namely the BETTY score, that aims to predict 30-day patient outcomes after surgery. In this first description, we rely on a population of prostate cancer patients undergoing robot-assisted radical prostatectomy. The BETTY score includes the patient’s American Society of Anesthesiologists score, the body mass index, and intraoperative data, including operative time, estimated blood loss, any major intraoperative complications, hemodynamic, and/or respiratory instability. There is an inverse relationship between the score and severity. Three clusters assessing the risk of postoperative events were defined: low, intermediate, and high risk of postoperative events. A total of 297 patients was included. The median length of hospital stay was 1 day (IQR1-2). Unplanned visits, readmissions, any complications, and serious complications occurred in 17.2%, 11.8%, 28.3%, and 5% of cases, respectively. We found a statistically significant correlation between the BETTY score and all endpoints analyzed (all p ≤ 0.01). A total of 275, 20, and 2 patients were classified as low-, intermediate-, and high-risk according to the BETTY scoring system, respectively. Compared with low-risk patients, patients at intermediate-risk were associated with worse outcomes for all endpoints analyzed (all p ≤ 0.04). Future studies, in various surgical subspecialties, are ongoing to confirm the usefulness of this easy-to-use score in routine.