PD07-06 PREDICTING OUTCOMES AFTER ADRENALECTOMY USING THE 5-ITEM FRAILTY INDEX (5I-FI) IN THE ACS-NSQIP DATABASE

Abstract

You have accessJournal of UrologyAdrenal (PD07)1 Sep 2021PD07-06 PREDICTING OUTCOMES AFTER ADRENALECTOMY USING THE 5-ITEM FRAILTY INDEX (5I-FI) IN THE ACS-NSQIP DATABASE Krishna Ravivarapu, Evan Garden, Alexander Small, Osama Al-Alao, and Michael Palese Krishna RavivarapuKrishna Ravivarapu More articles by this author , Evan GardenEvan Garden More articles by this author , Alexander SmallAlexander Small More articles by this author , Osama Al-AlaoOsama Al-Alao More articles by this author , and Michael PaleseMichael Palese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001975.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate the condensed 5-item frailty index (5i-FI) as a predictor of postoperative complications as well as healthcare resource utilization (HCRU) outcomes in a contemporary cohort of adrenalectomy patients. METHODS: All MIS and open adrenalectomy cases recorded in the National Surgical Quality Improvement Program database (2015-2018) were analyzed. Primary outcomes of interest were postoperative complications, classified as Clavien-Dindo (CD) I/II or CD IV, and increased HCRU. HCRU outcomes were prolonged (>75th percentile) length of stay (PLOS), discharge to continued care (DCC), and unplanned 30-day readmission (UR). 5-iFI score was calculated for each patient by adding one point for each of the following: impaired functional status, diabetes, chronic obstructive pulmonary disease, congestive heart failure within 30-days of surgery, and hypertension requiring medication. Multivariate logistic regressions were used to evaluate 5-iFI score groups (0, 1, 2, ≥3) as independent predictors of clinical and HCRU outcomes, adjusting for age, sex, BMI, race, hispanic ethnicity, smoking status, immunosuppressant use, MIS approach, malignant neoplasm, disseminated cancer, recent ascites, dialysis status, recent weight loss, and bleeding disorders. RESULTS: A total of 4358 patients were included, of which 3578 (82.1%) underwent MIS adrenalectomy. Higher 5i-FI scores were associated with higher rates of CDI/II, CDIV, and increased HCRU (p <0.05). Multivariate analysis controlling for available demographic, surgical, and pathologic factors showed that several 5i-FI scores are independent predictors of adverse clinical and HCRU outcomes (Table 1). CONCLUSIONS: The 5i-FI has potential as a practical frailty-based preoperative risk assessment tool in adrenalectomy. Understanding frailty is important for preoperative risk-benefit analysis, patient counseling, and planning prehabilitation interventions to minimize postoperative burdens. Further work is needed to balance the practicality, scope, and predictive accuracy of frailty assessment tools. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e107-e107 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Krishna Ravivarapu More articles by this author Evan Garden More articles by this author Alexander Small More articles by this author Osama Al-Alao More articles by this author Michael Palese More articles by this author Expand All Advertisement Loading ...