Mp29-05 the Modified 5-Item Frailty Index as a Predictor of Perioperative Risk in Patients Undergoing Percutaneous Nephrolithotomy

You have accessJournal of UrologyStone Disease: Surgical Therapy (Including ESWL) III (MP29)1 May 2024MP29-05 THE MODIFIED 5-ITEM FRAILTY INDEX AS A PREDICTOR OF PERIOPERATIVE RISK IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY Kays Chaker, Yassine Ouanes, Makram Rinchi, Mahdi Marrak, Mokhtar Bibi, Kheireddine Mrad Dali, Moez Rahoui, Karem Abid, and Yassine Nouira Kays ChakerKays Chaker , Yassine OuanesYassine Ouanes , Makram RinchiMakram Rinchi , Mahdi MarrakMahdi Marrak , Mokhtar BibiMokhtar Bibi , Kheireddine Mrad DaliKheireddine Mrad Dali , Moez RahouiMoez Rahoui , Karem AbidKarem Abid , and Yassine NouiraYassine Nouira View All Author Informationhttps://doi.org/10.1097/01.JU.0001008680.67760.37.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The modified 5-item frailty index is a relatively new tool to assess the post-operative complication risks. In urology, there is limited literature on the impact of frailty on percutaneous nephrolithotomy (PCNL) outcomes. We aimed to compare the predictive value of the modified 5-item frailty index (mFI-5) to identify high risk patients prior to PCNL. METHODS: A database of patients undergoing PCNL, between 2015 and 2021, was analyzed. Clinical and intra-operative data including, demographics, relevant labs, number of punctures, stone location, and stone characteristics were analyzed. Patient frailty was assessed using the mFI-5 index, which is assessed between 0 to 5 for the cumulative presence of the five components. The mFI-5 index was calculated based on the presence of the 5 co-morbidities: congestive heart failure within 30 days prior to surgery, diabetes mellitus, chronic obstructive pulmonary disease, partially dependent or totally dependent functional health status at time of surgery, and hypertension requiring medication. Patients were grouped as not frail (mFI-5=0), intermediate (mFI-5=1), and severely frail (mFI-5>2). Primary outcomes were 30-day postoperative complications. Secondary outcomes were hospital utilization: total hospital length of stay, reoperation, and unplanned readmission. ANOVA analyses, Chi-Squared analyses, and Spearman's correlations were conducted to determine potential group diferences and potential associations. A p value of<0.05 was considered statistically significant. RESULTS: From a total of 320 PCNL patients included for analysis, 54.06% (n=173) were not frail, 17.81% (n=57) were intermediate, and 28.12% (n=90) were severely frail. There were no differences in blood loss, number of dilations, presence of a staghorn calculus, laterality, or location of dilation. Frail patients were likely to be older (p=0.002) and have a higher American Society of Anesthesiologists score (p=0.001) and Charlson comorbidity index (p=0.03). Patients of intermediate or severe frailty were more likely to exhibit postoperative sepsis (p=0.042), significant blood loss (p=0.036) and require intensive care units admissions (p=0.0015). Frail patients had a longer hospital length of stay (p<0.001) and tended to require, reoperation, and unplanned readmission (p=0.02). CONCLUSIONS: Frailty assessment appears useful stratifying those at risk of extended hospitalization, septic and hemorrhagic complications, readmission, or reoperation after PCNL. Preoperative assessment of frailty phenotype may give insight into treatment decisions and assist surgeons in counselling patients on expected course and hospital stay following PCNL. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e482 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Kays Chaker More articles by this author Yassine Ouanes More articles by this author Makram Rinchi More articles by this author Mahdi Marrak More articles by this author Mokhtar Bibi More articles by this author Kheireddine Mrad Dali More articles by this author Moez Rahoui More articles by this author Karem Abid More articles by this author Yassine Nouira More articles by this author Expand All Advertisement PDF downloadLoading ...