A 5-Item Frailty Index for Predicting Morbidity and Mortality After Radical Prostatectomy: An Analysis of the American College of Surgeons National Surgical Quality Improvement Program Database

Shahait, Mohammed; Labban, Muhieddine; Dobbs, Ryan W.; Cheaib, Joseph G.; Lee, David I.; Tamim, Hani; Hajj, Albert El

doi:10.1089/end.2020.0597

Cited by 27 publications

(25 citation statements)

References 24 publications

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“…In the 711 remained studies, 689 were excluded based on titles and abstracts primarily due to irrelevancy. For the 22 potentially relevant studies, full-text review was performed and 17 were further excluded due to the reasons listed in Figure 1, which left five cohort studies (Lascano et al, 2015; Levy et al, 2017; Momota et al, 2020; Rosiello et al, 2020; Shahait et al, 2021) eligible for the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 shows the summarized study characteristics. Overall, five studies published between 2015 and 2021 with 171,929 patients with PCa who underwent radical prostatectomy (ORP or RARP) were included (Lascano et al, 2015; Levy et al, 2017; Momota et al, 2020; Rosiello et al, 2020; Shahait et al, 2021). One study reported the outcome data in patients receiving ORP and RARP separately (Shahait et al, 2021), which was independently included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…More importantly, it has been confirmed that compared to chronological age, frailty may be a better predictor for adverse postoperative complications in patients receiving surgeries for head and neck cancers (Mendes et al, 2021), digestive system tumors (Ding et al, 2021), and bladder cancer (Ornaghi et al, 2020). In patients with PCa, frailty has been suggested to predict the incidence of postoperative complications following radical prostatectomy (Lascano et al, 2015; Levy et al, 2017; Momota et al, 2020; Rosiello et al, 2020; Shahait et al, 2021), however, systematic evaluations with meta-analyses have not yet been performed. Accordingly, we performed a meta-analysis to comprehensively evaluate the association between frailty and the incidence of severe postoperative complications and mortality of patients with PCa following radical prostatectomy.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Frailty Assessment for Outcome Prediction of Patients With Prostate Cancer Receiving Radical Prostatectomy: A Meta-Analysis of Cohort Studies

Liu

Sun

2022

Clin Nurs Res

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A meta-analysis was conducted to investigate the association between frailty and postoperative complications in patients with prostate cancer following radical prostatectomy. A systematic search of PubMed, Embase, and Web of Science was conducted for relevant cohort studies. A random-effect model was chosen to combine the results. Five cohort studies including 171,929 patients were included. Results showed that patients with frailty had higher risk of severe postoperative complications (Clavien-Dindo IV complications, risk ratio [RR]: 1.87, 95% confidence interval [CI]: 1.67 to 2.10, p < .001; I2 = 18%) and all-cause mortality (RR: 2.89, 95% CI: 1.86 to 4.50, p < 0.001; I2 = 18%). Subgroup analyses showed consistent results in patients receiving open and robot-assisted radical prostatectomy, and also in studies with univariate and multivariate analyses. In conclusion, preoperative frailty may be a predictor of severe postoperative complications and all-cause mortality of patients with prostate cancer following radical prostatectomy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Frailty Assessment for Outcome Prediction of Patients With Prostate Cancer Receiving Radical Prostatectomy: A Meta-Analysis of Cohort Studies

Liu

Sun

2022

Clin Nurs Res

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“… 12 Other tools such as frailty indices have been evaluated to predict morbidity and mortality following RARP. 24 Strategies to mitigate postoperative morbidity are becoming central to a value-based health care system in the United States where there is a paradigm shift from fee-for-service to bundled payments. 25 As such, the preemptive optimization of medical comorbidities by a multidisciplinary team could mitigate or prevent postoperative adverse events.…”

Section: Discussionmentioning

confidence: 99%

Patient characteristics predicting prolonged length of hospital stay following robotic-assisted radical prostatectomy

El‐Hajj

Labban

Ploussard³

et al. 2022

Therapeutic Advances in Urology

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Objective: The objective of this study is to determine the preoperative patient characteristics predicting prolonged length of hospital stay (pLOS) following robotic-assisted radical prostatectomy (RARP). Methods: The National Surgical Quality Improvement Program (NSQIP) database was used to select patients who underwent RARP without other concomitant surgeries between 2008 and 2016. Patients’ demographics, comorbidities, and laboratory markers were collected to evaluate their role in predicting pLOS. The pLOS was defined as length of stay (LOS) >2 days. A multinomial logistic regression was constructed adjusting for postoperative surgical complications to assess for the predictors of pLOS. Results: We obtained data for 31,253 patients of which 20,774 (66.5%) patients stayed ⩽1 day, 6993 (22.4%) patients stayed for 2 days, and 3486 (11.2%) patients stayed for >2 days. Demographic variables – including body mass index (BMI) <18.5: odds ratio (OR) = 2.8, 95% confidence interval (CI) = [1.7–4.8]; smoking: OR = 1.2, 95% CI = [1.1–1.4]; and dependent functional status: OR = 3.1, 95% CI = [1.6–6.0] – were predictors of pLOS. Comorbidities – such as heart failure: OR = 4.6, 95% CI = [2.0–10.8]; being dialysis dependent: OR = 2.7, 95% CI = [1.4–5.0]; and predisposition to bleeding: OR = 2.0, 95% CI = [1.5–2.7] – were the strongest predictors of extended hospitalization. In addition, pLOS was more likely to be associated with postoperative bleeding, renal, or pulmonary complications. Conclusion: Preoperative patient characteristics and comorbidities can predict pLOS. These findings can be used preoperatively for risk assessment and patient counseling.

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“…Moreover, we designated composite morbidity as the combination of pulmonary, renal, infectious, MACE, VTE, and transfusion outcomes. We further categorized ACS-National Surgical Quality Improvement Program (NSQIP) surgical outcomes in Clavien-Dindo grades according to previously published studies [20,21]. Clavien-Dindo grade I and grade II represent occurrences of surgical site infection (SSI), deep incisional SSI, organ space SSI, fascial dehiscence, pneumonia, urinary tract infections, deep venous thrombosis, progressive renal insufficiency, bleeding requiring transfusion.…”

Section: Abbreviationsmentioning

confidence: 99%

Perioperative Outcomes of Anatomic Endoscopic Enucleation of the Prostate, Robotic and Open Simple Prostatectomy From a Multi-Institutional Database

Labban¹,

Heidar²,

Misraï³

et al. 2021

Société Internationale D’Urologie Journal

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Objective: To compare the perioperative morbidity of robotic-assisted simple prostatectomy (RASP), anatomical endoscopic enucleation of the prostate (AEEP) and open simple prostatectomy (OSP) for the treatment of benign prostatic obstruction (BPO). Methods: The national surgical quality improvement program database was queried for AEEP, RASP, and OSPprocedures. Clavien-Dindo-graded complications, length of hospital stay (LOS), and operative time were compared among the procedures. To control for the potentially confounding variables, we first conducted a multivariate backward conditional logistic regression, and then resorted to propensity score matching. Results: We identified 2867 AEEP, 234 RASP, and 1492 OSP procedures. After matching, the risk of pulmonary, renal, infectious, and thromboembolic adverse events was lower after AEEP but not RASP in comparison with OSP (P < 0.05). In comparison with RASP, AEEP had lower cardiac and thromboembolic events (P < 0.05). When compared with OSP, AEEP had reduced odds of Clavien-Dindo grade I (OR = 0.12; 95% CI 0.10 to 0.16) and II (OR = 0.38; 95% CI 0.24 to 9.58) complications. Also, AEEP had lower odds for grade I and II as well as grade IV complications (OR = 0.30; 95% CI 0.19 to 0.48, and OR = 0.05; 95% CI 0.01 to 0.24, respectively) compared with RASP. Conclusion: AEEP and RASP were associated with fewer perioperative adverse events, a shorter LOS and a reduced risk of transfusion compared with OSP. AEEP was associated with overall lower complication rates than RASP and OSP.

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A 5-Item Frailty Index for Predicting Morbidity and Mortality After Radical Prostatectomy: An Analysis of the American College of Surgeons National Surgical Quality Improvement Program Database

Cited by 27 publications

References 24 publications

Frailty Assessment for Outcome Prediction of Patients With Prostate Cancer Receiving Radical Prostatectomy: A Meta-Analysis of Cohort Studies

Frailty Assessment for Outcome Prediction of Patients With Prostate Cancer Receiving Radical Prostatectomy: A Meta-Analysis of Cohort Studies

Patient characteristics predicting prolonged length of hospital stay following robotic-assisted radical prostatectomy

Perioperative Outcomes of Anatomic Endoscopic Enucleation of the Prostate, Robotic and Open Simple Prostatectomy From a Multi-Institutional Database

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