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- Title
Impact of frailty on perioperative outcomes following percutaneous nephrolithotomy in older persons: evidence from the US Nationwide Inpatient Sample.
- Authors
Chien, You-Chiuan; Chen, Pao-Hwa; Chang, Yaw-Jen
- Abstract
To evaluate the impact of frailty on perioperative outcomes of older patients undergoing PCNL, utilizing the US Nationwide Inpatient Sample (NIS) database. Data of hospitalized patients ≥ 60 years who received PCNL were extracted from the 2010 to 2020 NIS database, and included demographics, clinical, and hospital-related information. Patients were assigned to low (< 5), medium (5–15), and high frailty risk (> 15) groups based on the hospital frailty risk score (HFRS). Associations between frailty risk and perioperative outcomes including total hospital cost were determined using population-weighted linear and logistic regression analyses. Data of 30,829 hospitalized patients were analyzed (mean age 72.5 years; 55% male; 78% white). Multivariable analyses revealed that compared to low frailty risk, increased frailty risk was significantly associated with elevated in-hospital mortality (adjusted odds ratio (aOR) = 10.70, 95% confidence interval (CI): 6.38–18.62), higher incidence of unfavorable discharge (aOR = 5.09, 95% CI: 4.43–5.86), prolonged hospital length of stay (LOS; aOR = 7.67, 95% CI: 6.38–9.22), increased transfusion risk (aOR = 8.05, 95% CI: 6.55–9.90), increased total hospital costs (adjusted Beta = 37.61, 95% CI: 36.39–38.83), and greater risk of complications (aOR = 8.52, 95% CI: 7.69–9.45). Frailty is a significant prognostic indicator of adverse perioperative outcomes in older patients undergoing PCNL, underscoring importance of recognizing and managing frailty in older patients.
- Subjects
PERCUTANEOUS nephrolithotomy; OLDER people; DISEASE risk factors; FRAILTY; LENGTH of stay in hospitals; LOGISTIC regression analysis
- Publication
Urolithiasis, 2024, Vol 52, Issue 1, p1
- ISSN
2194-7228
- Publication type
Article
- DOI
10.1007/s00240-024-01595-y