Preoperative frailty predicts postoperative complications and mortality in urology patients

Purpose Our objective was to determine the impact of preoperative frailty, as measured by validated Risk Analysis Index (RAI), on the occurrence of postoperative complications after urologic surgeries in a national database comprised of diverse practice groups and cases. Study design The National Su...

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Bibliographic Details
Published in:World journal of urology 2017-01, Vol.35 (1), p.21-26
Main Authors: Isharwal, Sudhir, Johanning, Jason M., Dwyer, Jennifer G., Schimid, Kendra K., LaGrange, Chad A.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Databases, Factual
Female
Frail Elderly
Humans
Male
Medicine
Medicine & Public Health
Mortality
Nephrology
Oncology
Original Article
Postoperative Complications - epidemiology
Retrospective Studies
Risk Assessment
Risk Factors
Urologic Surgical Procedures - adverse effects
Urology
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Summary:Purpose Our objective was to determine the impact of preoperative frailty, as measured by validated Risk Analysis Index (RAI), on the occurrence of postoperative complications after urologic surgeries in a national database comprised of diverse practice groups and cases. Study design The National Surgical Quality Improvement Program (NSQIP) database was queried from 2005 to 2011 for a list of abdominal, vaginal, transurethral and scrotal urological surgeries using Current Procedural Terminology codes. The study population was subdivided into two groups based on the nature of procedures performed: complex procedures (inpatient) and simple procedures (outpatient). Risk Analysis Index score was calculated using preoperative NSQIP variables to determine preoperative frailty. Major postoperative morbidities (pulmonary, cardiovascular, renal and infectious), mortality, return to operating room, discharge destination and readmission to the hospital were examined. Results The study identified 42,715 patients who underwent urological procedures, 25,693 complex and 17,022 simple procedures. Mean RAI score (range) was 7.75 (0–53). The majority of patients scored low on the RAI (90.57 % with RAI 
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-016-1845-z