Frailty Index accurately predicts postoperative complications after prostate surgery

The Five-item Frailty Index (5i-FI) is a tool used by physicians to predict surgical risk and postoperative complications after a procedure. Researchers from Brigham and Women's Hospital, a founding member of the Mass General Brigham healthcare system, looked at whether the 5i-FI could be used to predict surgical complications in endoscopic surgery for benign prostatic obstruction (BPO).

Patients who received either transurethral resection of the prostate (TURP) between 2009 and 2019, photoselective vaporization of the prostate (PVP), or laser enucleation of the prostate (LEP) were assessed for frailty using the 5i-FI. The frailty scores were then compared against any complications experienced, major complications, length of stay in the hospital, and 30-day postoperative readmission. The team found that a 5i-FI score greater than two is predictive of these instances.

"The 5-item Frailty Index is an easy tool that predicts postoperative complications after endoscopic surgery for benign prostatic hyperplasia," said first author Muhieddine Labban, MD, of the Division of Urology and the Center for Surgery and Public Health.

"After weighting for patients' frailty scores and demographics, LEP and PVP were associated with lower odds of complications and shorter hospital stays. Nevertheless, both LEP and PVP are less likely to be used among men with higher frailty scores," said senior author Quoc‐Dien Trinh, MD, of the Brigham's Division of Urology and Center for Surgery and Public Health. "Preoperative frailty assessment using the 5i-FI could improve risk stratification."

Reference:

Labban, M., Frego, N., Qian, Z. et al. Does the 5-item Frailty Index predict surgical complications of endoscopic surgical management for benign prostatic obstruction? An analysis of the ACS-NSQIP. World J Urol (2022). https://doi.org/10.1007/s00345-022-04151-8