PD43-09 A PREDICTOR OF MORBIDITY AND MORTALITY IN RADICAL NEPHRECTOMY PATIENTS: THE 5-ITEM FRAILTY INDEX IN a PROPENSITY MATCHED ANALYSIS

You have accessJournal of UrologyCME1 Apr 2023PD43-09 A PREDICTOR OF MORBIDITY AND MORTALITY IN RADICAL NEPHRECTOMY PATIENTS: THE 5-ITEM FRAILTY INDEX IN a PROPENSITY MATCHED ANALYSIS Christian Habib Ayoub, Elia Abou Chawareb, Abdallah Kasti, Jose M. EL-Asmar, Anthony Abou, and Albert EL Hajj Christian Habib AyoubChristian Habib Ayoub More articles by this author , Elia Abou ChawarebElia Abou Chawareb More articles by this author , Abdallah KastiAbdallah Kasti More articles by this author , Jose M. EL-AsmarJose M. EL-Asmar More articles by this author , Anthony AbouAnthony Abou More articles by this author , and Albert EL HajjAlbert EL Hajj More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003353.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The 5-item frailty index has been adopted as a preoperative evaluation method and has gained importance in predicting surgical outcomes. Hence, we aimed at assessing the ability of the 5-item frailty index score to predict 30-day morbidity and mortality post-radical nephrectomy (RN). METHODS: We used the American College of Surgeons – National Surgical Quality Improvement Program (ACS-NSQIP) database to select patients who underwent RN from 2011 to 2020. To calculate the 5-item frailty score, a point was assigned for each of the following comorbidities: chronic obstructive pulmonary disease or pneumonia, congestive heart failure, dependent functional status, hypertension, and diabetes. Patients were then divided into 3 frailty groups 0,1, and ≥2. Patient demographics, medical comorbidities, prolonged length of stay and operative time, mortality, and morbidity using the Clavien-Dindo (CVD) classification were compared between different groups. Multivariable logistic regression models and propensity score matching were then performed as a sensitivity analysis to control for possible confounders. RESULTS: The cohort consisted of 52,912 patients. Frailty classes consisted of 17,302 (32.7%) class 0, 23,740 (44.9%) class 1, and 11,870 (22.4%) class ≥2 patients. Patients with higher frailty class were more likely to be older, with higher ASA class, higher BMI, and comorbidities (p<0.001). After multivariable analysis and propensity score matching, patients with frailty classes 1 and ≥2 were more likely to have prolonged length of stay (OR=1.08, 1.25, respectively), mortality (OR=1.45, 1.84, respectively), CVD 1&2 (OR=1.52 for frailty class 1) and CVD≥4 (OR=1.36, 1.76, respectively) as compared to frailty class 0 (p<0.001). CONCLUSIONS: The 5-item frailty score was found to be an independent predictor of prolonged length of stay, morbidity, and mortality after RN. This tool could help in patient counseling and risk assessment before surgery. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1121 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Habib Ayoub More articles by this author Elia Abou Chawareb More articles by this author Abdallah Kasti More articles by this author Jose M. EL-Asmar More articles by this author Anthony Abou More articles by this author Albert EL Hajj More articles by this author Expand All Advertisement PDF downloadLoading ...