Adrenalectomy outcomes predicted by a 5-item frailty index (5-iFI) in the ACS-NSQIP database

Krishna T. Ravivarapu; Evan B. Garden; Osama Al-Alao; Alexander C. Small; Michael A. Palese

doi:10.1016/j.amjsurg.2021.11.020

Adrenalectomy outcomes predicted by a 5-item frailty index (5-iFI) in the ACS-NSQIP database

Krishna T. Ravivarapu, Evan B. Garden, Osama Al-Alao, Alexander C. Small, Michael A. Palese

Urology

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Background: Frailty has been shown to be a predictor of adverse postoperative outcomes. This study aims to evaluate a 5-item frailty index (5-iFI) as a predictor of complications as well as healthcare resource utilization (HCRU) following adrenalectomy. Methods: All adrenalectomy cases recorded in the ACS-NSQIP database from 2015 to 2018 were analyzed. Primary outcomes of interest were Clavien-Dindo [CD] I/II or CD IV complications and HCRU. HCRU outcomes were prolonged length of stay (PLOS), discharge to continued care (DCC), and unplanned 30-day readmission (UR). Results: 4358 patients were included. Higher 5-iFI scores were associated with higher rates of CDI/II, CDIV, and increased HCRU (p < 0.05). On multivariate analysis, 5-iFI scores were found to be independent predictors of adverse clinical and HCRU outcomes. Conclusions: Frailty tools like the 5i-FI can be useful in preoperative risk-benefit analysis, patient counseling, and planning prehabilitation interventions.

Original language	English (US)
Pages (from-to)	1120-1125
Number of pages	6
Journal	American Journal of Surgery
Volume	223
Issue number	6
DOIs	https://doi.org/10.1016/j.amjsurg.2021.11.020
State	Published - Jun 2022

Keywords

Adrenalectomy
Frailty
Outcomes
Postoperative complications
Risk factors

ASJC Scopus subject areas

Surgery

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10.1016/j.amjsurg.2021.11.020

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@article{1793ebc311534314987ef08270e7722f,

title = "Adrenalectomy outcomes predicted by a 5-item frailty index (5-iFI) in the ACS-NSQIP database",

abstract = "Background: Frailty has been shown to be a predictor of adverse postoperative outcomes. This study aims to evaluate a 5-item frailty index (5-iFI) as a predictor of complications as well as healthcare resource utilization (HCRU) following adrenalectomy. Methods: All adrenalectomy cases recorded in the ACS-NSQIP database from 2015 to 2018 were analyzed. Primary outcomes of interest were Clavien-Dindo [CD] I/II or CD IV complications and HCRU. HCRU outcomes were prolonged length of stay (PLOS), discharge to continued care (DCC), and unplanned 30-day readmission (UR). Results: 4358 patients were included. Higher 5-iFI scores were associated with higher rates of CDI/II, CDIV, and increased HCRU (p < 0.05). On multivariate analysis, 5-iFI scores were found to be independent predictors of adverse clinical and HCRU outcomes. Conclusions: Frailty tools like the 5i-FI can be useful in preoperative risk-benefit analysis, patient counseling, and planning prehabilitation interventions.",

keywords = "Adrenalectomy, Frailty, Outcomes, Postoperative complications, Risk factors",

author = "Ravivarapu, {Krishna T.} and Garden, {Evan B.} and Osama Al-Alao and Small, {Alexander C.} and Palese, {Michael A.}",

note = "Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",

year = "2022",

month = jun,

doi = "10.1016/j.amjsurg.2021.11.020",

language = "English (US)",

volume = "223",

pages = "1120--1125",

journal = "American Journal of Surgery",

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T1 - Adrenalectomy outcomes predicted by a 5-item frailty index (5-iFI) in the ACS-NSQIP database

AU - Ravivarapu, Krishna T.

AU - Garden, Evan B.

AU - Al-Alao, Osama

AU - Small, Alexander C.

AU - Palese, Michael A.

PY - 2022/6

Y1 - 2022/6

N2 - Background: Frailty has been shown to be a predictor of adverse postoperative outcomes. This study aims to evaluate a 5-item frailty index (5-iFI) as a predictor of complications as well as healthcare resource utilization (HCRU) following adrenalectomy. Methods: All adrenalectomy cases recorded in the ACS-NSQIP database from 2015 to 2018 were analyzed. Primary outcomes of interest were Clavien-Dindo [CD] I/II or CD IV complications and HCRU. HCRU outcomes were prolonged length of stay (PLOS), discharge to continued care (DCC), and unplanned 30-day readmission (UR). Results: 4358 patients were included. Higher 5-iFI scores were associated with higher rates of CDI/II, CDIV, and increased HCRU (p < 0.05). On multivariate analysis, 5-iFI scores were found to be independent predictors of adverse clinical and HCRU outcomes. Conclusions: Frailty tools like the 5i-FI can be useful in preoperative risk-benefit analysis, patient counseling, and planning prehabilitation interventions.

AB - Background: Frailty has been shown to be a predictor of adverse postoperative outcomes. This study aims to evaluate a 5-item frailty index (5-iFI) as a predictor of complications as well as healthcare resource utilization (HCRU) following adrenalectomy. Methods: All adrenalectomy cases recorded in the ACS-NSQIP database from 2015 to 2018 were analyzed. Primary outcomes of interest were Clavien-Dindo [CD] I/II or CD IV complications and HCRU. HCRU outcomes were prolonged length of stay (PLOS), discharge to continued care (DCC), and unplanned 30-day readmission (UR). Results: 4358 patients were included. Higher 5-iFI scores were associated with higher rates of CDI/II, CDIV, and increased HCRU (p < 0.05). On multivariate analysis, 5-iFI scores were found to be independent predictors of adverse clinical and HCRU outcomes. Conclusions: Frailty tools like the 5i-FI can be useful in preoperative risk-benefit analysis, patient counseling, and planning prehabilitation interventions.

KW - Adrenalectomy

KW - Frailty

KW - Outcomes

KW - Postoperative complications

KW - Risk factors

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Adrenalectomy outcomes predicted by a 5-item frailty index (5-iFI) in the ACS-NSQIP database

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