MP65-11 FRAILTY AMONG BLADDER AUGMENTATION PATIENTS: HEALTH CARE UTILIZATION AND PERIOPERATIVE OUTCOMES

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP65-11 FRAILTY AMONG BLADDER AUGMENTATION PATIENTS: HEALTH CARE UTILIZATION AND PERIOPERATIVE OUTCOMES Anthony Fadel, Bridget L. Findlay, Boyd R. Viers, and Katherine T. Anderson Anthony FadelAnthony Fadel More articles by this author , Bridget L. FindlayBridget L. Findlay More articles by this author , Boyd R. ViersBoyd R. Viers More articles by this author , and Katherine T. AndersonKatherine T. Anderson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003323.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: As the population ages, frailty is becoming a more pressing concern for many medical and surgical patients. Studies in urologic oncology have demonstrated an association between frailty and increased utilization of health care resources and 30-day morbidity. There is a paucity of literature surrounding frailty in patients undergoing benign pelvic reconstructive surgery. Herein, we aim to study the impact of frailty on healthcare utilization and perioperative outcomes following adult bladder augmentation. METHODS: Data was collected from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2005-2020 on adult patients who underwent bladder augmentation for various indications. A frailty score was assigned to each patient according to the Five Item Frailty Index (DMII, HTN, COPD, functional health status, and CHF). Baseline characteristics were compared across frailty scores. Univariate and multivariate risk-adjusted regression models were developed to identify predictors of healthcare utilization (i.e., prolonged length of stay (PLOS), 30-day readmissions (AR), discharge to continued care (DCC), and overall resource utilization (HRU) which is a composite of the other 3 outcomes). Secondary outcomes of interest included 30-day complication rates. RESULTS: 941 patients underwent bladder augmentation during the study period, the majority were males (75%) with a median age of 60. An increase in frailty index was significantly associated with an increase in HRU (p-value<0.05, Figure 1), even after adjusting for baseline characteristics such as ASA class. In addition, female sex was associated with lower HRU (OR 0.32, p-value < 0.001). Patients with higher frailty (≥2) also had more complications (28.9%) compared to those with a lower frailty index of≤1 (12.8%, p-value<0.001). CONCLUSIONS: Frailty in adults undergoing bladder augmentation is associated with greater HRU and surgical morbidity. Our study highlights the importance of frailty in benign pelvic surgery as well as the need for future studies directed at interventions to optimize frail patients. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e895 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anthony Fadel More articles by this author Bridget L. Findlay More articles by this author Boyd R. Viers More articles by this author Katherine T. Anderson More articles by this author Expand All Advertisement PDF downloadLoading ...