Preoperative frailty predicts postoperative complications and mortality in urology patients.


PURPOSE:Our objective was to determine the impact of preoperative frailty, as measured by validated Risk Analysis Index (RAI), on the occurrence of postoperative complications after urologic surgeries in a national database comprised of diverse practice groups and cases. STUDY DESIGN:The National Surgical Quality Improvement Program (NSQIP) database was queried from 2005 to 2011 for a list of abdominal, vaginal, transurethral and scrotal urological surgeries using Current Procedural Terminology codes. The study population was subdivided into two groups based on the nature of procedures performed: complex procedures (inpatient) and simple procedures (outpatient). Risk Analysis Index score was calculated using preoperative NSQIP variables to determine preoperative frailty. Major postoperative morbidities (pulmonary, cardiovascular, renal and infectious), mortality, return to operating room, discharge destination and readmission to the hospital were examined. RESULTS:The study identified 42,715 patients who underwent urological procedures, 25,693 complex and 17,022 simple procedures. Mean RAI score (range) was 7.75 (0-53). The majority of patients scored low on the RAI (90.57 % with RAI < 10). As the RAI score increased, there was a significant increase in postoperative complication and mortality rate (both p < 0.0001). Similarly, the rate of return to operating room and hospital readmission rate increased as RAI increased (both p < 0.0001). Additionally, rate of discharge to home decreased. Interestingly, mortality rate in patients with high RAI did not differ comparing simple to complex procedures (p = 0.90), whereas complications were significantly greater in the complex operation (p = 0.01). CONCLUSIONS:Increase in frailty, as measured by RAI score, is associated with increased postoperative complications and mortality. RAI may allow for rapid identification and counseling of patients who are at high risk of adverse perioperative outcomes.


World J Urol


World journal of urology


Isharwal S,Johanning JM,Dwyer JG,Schimid KK,LaGrange CA




Has Abstract


2017-01-01 00:00:00














  • The effects of testosterone on the cavernous tissue and erectile function.

    abstract::A review of the current literature is conducted to explore the developmental aspects, animal and human experiences and the effects of pharmacological manipulation to explain the role androgens play in sexual function with special emphasis on erectile function and the erectile tissue. This review reveals that androgens...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Shabsigh R

    更新日期:1997-01-01 00:00:00

  • Controlled, double-blind, multicentre clinical trial to investigate long-term tolerability and efficacy of trospium chloride in patients with detrusor instability.

    abstract::Our objectives were to ascertain the tolerability and efficacy of trospium chloride in doses of 20 mg twice daily for long-term therapy (52 weeks) in patients with urge syndrome. The trial comprised a total of 358 patients with urge syndrome or urge incontinence. After randomisation in the ratio of 3:1, participants w...

    journal_title:World journal of urology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Halaska M,Ralph G,Wiedemann A,Primus G,Ballering-Brühl B,Höfner K,Jonas U

    更新日期:2003-05-01 00:00:00

  • Treatment of renal calcium stone disease with the synthetic glycosaminoglycan pentosan polysulphate.

    abstract::Glycosaminoglycans (GAGs) are potent inhibitors of calcium oxalate growth and aggregation. The synthetic GAG pentosan polysulphate (PPS) was used in the treatment of patients with renal calcium stone disease. Altogether, 121 patients were included in an open trial over a 3-year-period. The average stone episode rate a...

    journal_title:World journal of urology

    pub_type: 临床试验,杂志文章


    authors: Fellström B,Backman U,Danielson B,Wikström B

    更新日期:1994-01-01 00:00:00

  • Are warm ischemia and ischemia time still predictive factors of poor renal function after partial nephrectomy in the setting of elective indication?

    abstract:PURPOSE:To evaluate renal function and to identify factors associated with renal dysfunction in the elective indications setting of nephron-sparing surgery (NSS). METHODS:We retrospectively reviewed operative data and glomerular filtration rate (GFR) of 519 patients treated by NSS in an elective indications setting be...

    journal_title:World journal of urology

    pub_type: 杂志文章,多中心研究


    authors: Bessede T,Bigot P,Bernhard JC,Pignot G,Boulière F,Verhoest G,Crépel M,Salomon L,Mottet N,Bellec L,Soulié M,Ferrière JM,Pfister C,Albouy B,Pouliot F,Dujardin T,Bensalah K,Patard JJ

    更新日期:2015-01-01 00:00:00

  • Histologic characterization of the post-radiation urethral stenosis in men treated for prostate cancer.

    abstract:PURPOSE:To evaluate histological changes in stenotic urethral tissue post-radiation therapy. Treatment of prostate cancer by radiation therapy carries a risk of off-target injury to the membranous urethra causing urethral stenosis. Limited characterization of post-radiation urethral stenosis exists in the literature. W...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Hughes M,Caza T,Li G,Daugherty M,Blakley S,Nikolavsky D

    更新日期:2020-09-01 00:00:00

  • The role of MRI for detection and staging of radio- and focal therapy-recurrent prostate cancer.

    abstract::Local recurrent prostate cancer after radical treatment is found in the majority of men with a rising PSA. Salvage treatment procedures for recurrent disease, such as radiation therapy and ablative procedures, can provide long-term responses in well-selected cases. Prostate magnetic resonance imaging (MRI) allows diag...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: van der Poel H,Grivas N,van Leeuwen P,Heijmink S,Schoots I

    更新日期:2019-08-01 00:00:00

  • UTI in kidney transplant.

    abstract::Urinary tract infection (UTI) remains the most common type of infection contracted by kidney transplant patients. UTI reduces both patient and graft survival. Understanding and managing UTI in transplant patients requires an appreciation of their unique anatomy and physiology. Both the transplant and native urinary sy...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Ness D,Olsburgh J

    更新日期:2020-01-01 00:00:00

  • Effect of testosterone, raloxifene and estrogen replacement on the microstructure and biomechanics of metaphyseal osteoporotic bones in orchiectomized male rats.

    abstract:INTRODUCTION:Currently, osteoporosis research is rarely undertaken in males but an increase in male life expectancy in the company of hypogonadism suggests the necessity for potential therapeutic options. MATERIALS AND METHODS:In this study, the changes in bone structure under standardized testosterone- (T), raloxifen...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Stuermer EK,Sehmisch S,Tezval M,Tezval H,Rack T,Boekhoff J,Wuttke W,Herrmann TR,Seidlova-Wuttke D,Stuermer KM

    更新日期:2009-08-01 00:00:00

  • Long-term outcomes of transobturator tension-free vaginal tapes as secondary continence procedures.

    abstract:PURPOSE:To assess the long-term patient-reported outcomes following TO-TVT as a secondary continence procedure in women with recurrent stress urinary incontinence (R-SUI). METHODS:A secondary analysis of the 9-year follow-up of the E-TOT study was performed: 341 women with predominant SUI symptoms were randomised to u...

    journal_title:World journal of urology

    pub_type: 杂志文章,随机对照试验


    authors: Abdel-Fattah M,Cao G,Mostafa A

    更新日期:2017-07-01 00:00:00

  • GPX2 underexpression indicates poor prognosis in patients with urothelial carcinomas of the upper urinary tract and urinary bladder.

    abstract:PURPOSE:Oxidative stress is believed to be one of the important etiologies in carcinogenesis that has not been systemically investigated in urothelial carcinoma (UC). Through data mining from a published transcriptomic database of UC of urinary bladders (UBUCs) (GSE31684), glutathione peroxidase 2 (GPX2) was identified...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Chang IW,Lin VC,Hung CH,Wang HP,Lin YY,Wu WJ,Huang CN,Li CC,Li WM,Wu JY,Li CF

    更新日期:2015-11-01 00:00:00

  • Complications of robotic assisted radical prostatectomy.

    abstract:OBJECTIVES:Robotic radical prostatectomy claims optimal oncologic results, minimal morbidity and best outcomes of urinary continence and erection function. Potential benefits concerning side effects and complications compared to open radical prostatectomy are analysed. METHODS:Out of 450 robotic radical prostatectomie...

    journal_title:World journal of urology

    pub_type: 杂志文章,meta分析,多中心研究


    authors: Fischer B,Engel N,Fehr JL,John H

    更新日期:2008-12-01 00:00:00

  • Obstructive sleep apnea and Fuhrman grade in patients with clear cell renal cell carcinoma treated surgically.

    abstract:PURPOSE:To assess the association between obstructive sleep apnea (OSA) and Fuhrman grade in patients with clear cell renal cell carcinoma (ccRCC). As secondary endpoints, we studied its association with tumor size, metastasis-free survival (MFS) and cancer-specific survival (CSS). METHODS:We reviewed the databases of...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Vilaseca A,Nguyen DP,Vertosick EA,Corradi RB,Musquera M,Pérez M,Fossati N,Sjoberg DD,Farré R,Almendros I,Montserrat JM,Benfante NE,Hakimi AA,Skanderup AJ,Russo P,Alcaraz A,Touijer KA

    更新日期:2017-01-01 00:00:00

  • Orchialgia and the chronic pelvic pain syndrome.

    abstract::This review paper highlights the important health issue of orchialgia and the chronic pelvic pain syndrome. There are a number of specific and non-specific etiologies and different treatment options based on the sub-categorization of orchialgia. The focus of this article is on the specific etiologies of chronic orchia...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Kavoussi PK,Costabile RA

    更新日期:2013-08-01 00:00:00

  • Clinical and pathological outcomes of renal cell carcinoma (RCC) in native kidneys of patients with end-stage renal disease: a long-term comparative retrospective study with RCC diagnosed in the general population.

    abstract:PURPOSE:Patients with end-stage renal disease (ESRD) have an increased risk of developing renal cell carcinoma (RCC). This retrospective study compared clinical and pathological outcomes of RCC occurring in native kidneys of patients with ESRD (whether they underwent kidney transplantation or not) with those of renal t...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Breda A,Lucarelli G,Rodriguez-Faba O,Guirado L,Facundo C,Bettocchi C,Gesualdo L,Castellano G,Grandaliano G,Battaglia M,Palou J,Ditonno P,Villavicencio H

    更新日期:2015-01-01 00:00:00

  • The role of [(18)F] FDG-PET, CT/MRI and tumor marker kinetics in the evaluation of post chemotherapy residual masses in metastatic germ cell tumors--prospects for management.

    abstract::The purpose of this study was to assess the ability of [(18)F]FDG-PET, CT/MRI and serum tumor marker (TM) to predict the viability of residual masses after high-dose chemotherapy (HD-Ctx) in patients with metastatic germ cell tumors (GCT). In a prospective study, 60 residual tumors in 28 GCT patients were classified a...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Pfannenberg AC,Oechsle K,Bokemeyer C,Kollmannsberger C,Dohmen BM,Bares R,Hartmann JT,Vonthein R,Claussen CD

    更新日期:2004-06-01 00:00:00

  • Prediction of perioperative outcomes following minimally invasive partial nephrectomy: role of the R.E.N.A.L nephrometry score.

    abstract:OBJECTIVES:Objective characterization of renal mass anatomy facilitates treatment selection and prediction of surgical outcomes. We investigated R.E.N.A.L nephrometry score (NS) efficacy in predicting outcomes after minimally invasive nephron-sparing surgery (MINSS). METHODS:A total of 250 patients with 252 renal mass...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Liu ZW,Olweny EO,Yin G,Faddegon S,Tan YK,Han WK,Cadeddu JA

    更新日期:2013-10-01 00:00:00

  • Prostate-specific antigen kinetics after I125-brachytherapy for prostate adenocarcinoma.

    abstract:PURPOSE:To investigate a potential correlation between the achievement of a cut-off of nadir PSA (nPSA) after brachytherapy (BRT) with biochemical Disease-Free Survival (bDFS) and to define the rate of post-BRT PSA bounces. METHODS:Retrospective analysis was carried out in 105 consecutive patients affected with early-...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Guarneri A,Botticella A,Ragona R,Filippi AR,Munoz F,Casetta G,Gontero P,Tizzani A,Ricardi U

    更新日期:2013-04-01 00:00:00

  • Outcome profiles of locoregional disease after radical prostatectomy and radiotherapy.

    abstract::The purpose of the present study was to examine the outcome profiles of a large number of patients with locally advanced adenocarcinoma of the prostate following radical perineal prostatectomy (RPP) for clinically organ-confined disease. Of 1662 men who underwent RPP performed by a single surgeon between January 1972 ...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Dahm P,Vieweg J,Newhall PM,Robertson JE,Paulson DF

    更新日期:2000-06-01 00:00:00

  • Multiparametric magnetic resonance imaging for prostate cancer-a comparative study including radical prostatectomy specimens.

    abstract:PURPOSE:To evaluate the diagnostic and staging ability of multiparametric MRI (mpMRI) compared to radical prostatectomy (RP) specimens after dissemination of this technology to several centres. mpMRI is an evolving technique aiming to improve upon the diagnostic sensitivity of prostate biopsy for the diagnosis of prost...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Toner L,Papa N,Perera M,Katelaris N,Weerakoon M,Chin K,Harewood L,Bolton DM,Lawrentschuk N

    更新日期:2017-06-01 00:00:00

  • Multicenter evaluation of the role of UroVysion FISH assay in surveillance of patients with bladder cancer: does FISH positivity anticipate recurrence?

    abstract:BACKGROUND:The significance of a positive UroVysion FISH assay is uncertain in patients with normal cystoscopy. This multicenter study evaluates the clinical significance of a positive FISH assay in patients with no visible tumor and excluding those with a positive cytology. METHODS:A multi-institutional, retrospectiv...

    journal_title:World journal of urology

    pub_type: 杂志文章,多中心研究


    authors: Seideman C,Canter D,Kim P,Cordon B,Weizer A,Oliva I,Rao J,Inman BA,Posch M,Herr H,Lotan Y

    更新日期:2015-09-01 00:00:00

  • Evaluation of renal function in patients with a main renal stone larger than 1 cm and perioperative renal functional change in minimally invasive renal stone surgery: a prospective, observational study.

    abstract:PURPOSE:To compare the perioperative relative renal function and determine predictors of deterioration and recovery of separate renal function in patients with renal stones >10 mm and who underwent mini-percutaneous nephrolithotomy or retrograde intra-renal surgery. PATIENTS AND METHODS:A main stone >10 mm or stones g...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Piao S,Park J,Son H,Jeong H,Cho SY

    更新日期:2016-05-01 00:00:00

  • Optimizing male fertility: oxidative stress and the use of antioxidants.

    abstract:PURPOSE:Management of male infertility is always a difficult task, with pathophysiology and available treatments often poorly understood. The purpose of this review was to summarize current evidence regarding the use of protective agents against reactive oxygen species (ROS), such as antioxidants that may be useful in ...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Cardoso JP,Cocuzza M,Elterman D

    更新日期:2019-06-01 00:00:00

  • Holmium:YAG laser ureteroscopic lithotripsy for ureteric calculi in children: predictive factors for complications and success.

    abstract:OBJECTIVES:To evaluate the impact of age, stone size, location, radiolucency, extraction of stone fragments, size of ureteroscope and presence and degree of hydronephrosis on the efficacy and safety of holmium:YAG (Ho:YAG) laser lithotripsy in the ureteroscopic treatment of ureteral stones in children. METHODS:Between...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Elsheemy MS,Maher A,Mursi K,Shouman AM,Shoukry AI,Morsi HA,Meshref A

    更新日期:2014-08-01 00:00:00

  • Is a wider angle of the membranous urethra associated with incontinence after radical prostatectomy?

    abstract:PURPOSE:To investigate whether differences in the anatomy and dynamics of the pelvic floor (PF) in patients after radical prostatectomy (RP) depicted on magnetic resonance imaging (MRI) are associated with continence status. METHODS:In the prospective designed study, 24 patients with post-prostatectomy stress urinary ...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Soljanik I,Bauer RM,Becker AJ,Stief CG,Gozzi C,Solyanik O,Brocker KA,Kirchhoff SM

    更新日期:2014-12-01 00:00:00

  • Effect of pelvic floor muscle contraction on vesical and rectal function with identification of puborectalis-rectovesical inhibitory reflex and levator-rectovesical excitatory reflex.

    abstract::The effects of pelvic floor muscle contraction on rectal and vesical function were studied in 19 healthy volunteers with the aim of shedding light on some of the hitherto vague aspects of the mechanisms involved in micturition and defecation and their disorders. Rectal and vesical pressures were recorded during pubore...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Shafik A,El-Sibai O

    更新日期:2001-08-01 00:00:00

  • A population-based survey of lower urinary tract symptoms (LUTS) and symptom-specific bother: results from the Brazilian LUTS epidemiology study (BLUES).

    abstract:PURPOSE:To examine the prevalence of lower urinary tract symptoms (LUTS) and the bother they impose in a population-based sample of adults in Brazil. METHODS:A cross-sectional population-based survey was conducted between September 2006 and January 2007 in the city of Salvador, Brazil. Cluster samples of representativ...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Moreira ED Jr,Neves RC,Neto AF,Duarte FG,Moreira TL,Lobo CF,Glasser DB

    更新日期:2013-12-01 00:00:00

  • Health-related quality-of-life studies in urology: conceptual and methodological considerations.

    abstract::This paper provides an overview of the scientific and practical aspects of assessing health-related quality of life (HRQL). The paper provides a brief overview of developments in the field and then discusses the definition of HRQL. The different types of HRQL measure available to researchers are described, with specif...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Browne JP

    更新日期:1999-08-01 00:00:00

  • Factors predicting inguinal node metastasis in squamous cell cancer of penis.

    abstract:PURPOSE:To identify factors predicting the risk of inguinal metastasis in squamous cell carcinoma of the penis. The therapeutic advantages of early lymphadenectomy in squamous cell carcinoma of the penis must be counterbalanced against its post-operative morbidity. Loss to follow up is a major problem in developing cou...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Bhagat SK,Gopalakrishnan G,Kekre NS,Chacko NK,Kumar S,Manipadam MT,Samuel P

    更新日期:2010-02-01 00:00:00

  • Long-term functional outcomes after robotic vs. retropubic radical prostatectomy in routine care: a 6-year follow-up of a large German health services research study.

    abstract:PURPOSE:To compare long-term functional outcomes after robotic vs. retropubic RP for patients with localized prostate cancer in routine care. METHODS:"HAROW" was a large German noninterventional health services research study that prospectively evaluated the treatment of patients with localized prostate cancer (≤ T2c)...

    journal_title:World journal of urology

    pub_type: 杂志文章


    authors: Baunacke M,Schmidt ML,Thomas C,Groeben C,Borkowetz A,Koch R,Chun FK,Weissbach L,Huber J

    更新日期:2020-07-01 00:00:00

  • Managing complications of collagenase Clostridium histolyticum (CCH) injection.

    abstract:PURPOSE:The introduction of collagenase Clostridium histolyticum (CCH) has revolutionized the treatment of Peyronie's disease. The efficacy of this therapy has been well demonstrated and the safety profile is favorable. However, post-injection complications are poorly characterized and management of these complications...

    journal_title:World journal of urology

    pub_type: 杂志文章,评审


    authors: Greear GM,Koprowski CJ,Hsieh TC

    更新日期:2020-02-01 00:00:00