We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
A 5-Item Frailty Index for Predicting Morbidity and Mortality After Radical Prostatectomy: An Analysis of the American College of Surgeons National Surgical Quality Improvement Program Database.
- Authors
Shahait, Mohammed; Labban, Muhieddine; Dobbs, Ryan W.; Cheaib, Joseph G.; Lee, David I.; Tamim, Hani; El-Hajj, Albert
- Abstract
Introduction: Current preoperative evaluation methods fail to detect the difference in frailty among patients with the same chronological age. Hence, we sought to assess the ability of a simple 5-item frailty index (5-iFI) score to predict surgical outcomes post radical prostatectomy (RP). Methods: The American College of Surgeons National Surgical Quality Improvement Program was queried for patients who underwent RP between 2008 and 2017. The 5-iFI score was calculated by assigning a point for each of the following conditions: (1) chronic obstructive pulmonary disease or pneumonia, (2) congestive heart failure, (3) dependent functional status, (4) hypertension, and (5) diabetes. Multivariable regression was performed to assess the association between the 5-iFI score and perioperative outcomes. Results: The cohort included 15,546 (46.2%), 14,541 (46.2%), and 3556 (10.6%) patients with 5-iFI scores of 0, 1, and ≥2, respectively. Patients >65 years, nonwhite, and with an American Society of Anesthesiology ≥3 were more likely to have a 5-iFI score ≥2 (p < 0.0001). Similarly, a 5-iFI ≥2 score was associated with higher Clavien–Dindo grades complications (p-trend <0.0001). In addition, a 5-iFI score ≥2 had 1.66 (1.31–2.11) and 1.85 (1.39–2.46) times the odds of Clavien–Dindo grades ≥3 and ≥4 adverse events, respectively. Moreover, a 5-iFI score ≥2 had 28% increased risk of length of stay >1 day (p < 0.0001) and increased incidence of early mortality (p = 0.01). Conclusions: Frailty, as measured by a simple 5-point frailty index, is an independent predictor of adverse outcomes and early mortality in patients undergoing RP. Preoperative frailty assessment may improve risk stratification and patient counseling before surgery.
- Subjects
AMERICAN College of Surgeons; RADICAL prostatectomy; OBSTRUCTIVE lung diseases; CONGESTIVE heart failure; SURGEONS; PROSTATECTOMY; TYPE 2 diabetes
- Publication
Journal of Endourology, 2021, Vol 35, Issue 4, p483
- ISSN
0892-7790
- Publication type
Article
- DOI
10.1089/end.2020.0597