078IC - Developing a Data-Driven Approach to Preoperative Risk Stratification to Guide Personalized Treatment Election, Prehabilitation, and Perioperative Management of Older and Medically Complex Patients

Monday, May 1, 2023

10:00 AM – 12:00 PM CST

Location: S102B

Instructional Course Director(s)

Sarah Psutka, MD

University of Washington

Instructional Course Faculty(s)

Bernard Bochner, MD

MD
Memorial Sloan Kettering Cancer Center
Tullika Garg, MD,MPH (she/her/hers)

Penn State Health Milton S. Hershey Medical Center
Viraj Master, MD, PHD

Emory University

Course Description: This course will focus on providing a data-driven systematic approach to comprehensively risk-stratifying patients at diagnosis in a data-driven fashion. We will review the current pitfalls of ubiquitous risk-stratification tools such as age, comorbidity, performance status and body mass index. We will then present a systematic approach that is immediately adoptable to clinical practice to help learners measure multidimensional and validated measures of risk and resilience including frailty and multimorbidity. We will present efficient techniques to integrate validated geriatric assessment tools into your practice to generate quantitative assessments of risk that can then inform shared decision making around further pretreatment testing, personalized treatment election and identification of vulnerabilities that can be targeted with pretreatment interventions (e.g., prehabilitation) to improve clinical outcomes for patients. Finally, we will highlight how these tools can guide not only selection for pretreatment interventions, but also perioperative management with the goal of enhancing recovery and mitigating operative risk.

Learning Objectives:

Identify the key limitations of traditional risk assessment tools, and characterize the knowledge gaps that exist in terms of how urologists evaluate the fitness of their patients for surgical intervention.
Describe validated, easily accessible tools that leverage well-defined principles of aging research to risk-stratify older and medically complex patients in their practices to estimate life expectancy, personalized treatment-specific risks of complications and functional outcomes that can then be integrated into a surgeon’s clinical practice.
Develop a personalized systematic approach to preoperative risk assessment that can be broadly applied across patients to inform shared decision making regarding personalized treatment election as well as prehabilitation interventions.
Discuss integration of risk-specific interventions into intraoperative and perioperative management strategies to enhance recovery following complex urological surgeries.