Frailty, Length of Stay, and Mortality in Kidney Transplant Recipients: A National Registry and Prospective Cohort Study.


OBJECTIVE:To test whether frailty, a novel measure of physiologic reserve, is associated with longer kidney transplant (KT) length of stay (LOS), and modifies the association between LOS and mortality. BACKGROUND:Better understanding of LOS is necessary for informed consent and discharge planning. Mortality resulting from longer LOS has important regulatory implications for hospital and transplant programs. Which recipients are at risk of prolonged LOS and its effect on mortality are unclear. Frailty is a novel preoperative predictor of poor KT outcomes including delayed graft function, early hospital readmission, immunosuppression intolerance, and mortality. METHODS:We used registry-augmented hybrid methods, a novel approach to risk adjustment, to adjust for LOS risk factors from the Scientific Registry of Transplant Recipients (n = 74,859) and tested whether (1) frailty, measured immediately before KT in a novel cohort (n = 589), was associated with LOS (LOS: negative binomial regression; LOS ≥2 weeks: logistic regression) and (2) whether frailty modified the association between LOS and mortality (interaction term analysis). RESULTS:Frailty was independently associated with longer LOS [relative risk = 1.15, 95% confidence interval (CI): 1.03-1.29; P = 0.01] and LOS ≥2 weeks (odds ratio = 1.57, 95% CI: 1.06-2.33; P = 0.03) after accounting for registry-based risk factors, including delayed graft function. Frailty also attenuated the association between LOS and mortality (nonfrail hazard rate = 1.55 95% CI: 1.30-1.86; P < 0.001; frail hazard rate = 0.97, 95% CI: 0.79-1.19, P = 0.80; P for interaction = 0.001). CONCLUSIONS:Frail KT recipients are more likely to experience a longer LOS. Longer LOS among nonfrail recipients may be a marker of increased mortality risk. Frailty is a measure of physiologic reserve that may be an important clinical marker of longer surgical LOS.


Ann Surg


Annals of surgery


McAdams-DeMarco MA,King EA,Luo X,Haugen C,DiBrito S,Shaffer A,Kucirka LM,Desai NM,Dagher NN,Lonze BE,Montgomery RA,Walston J,Segev DL




Has Abstract


2017-12-01 00:00:00












  • Traumatic injury to the portal vein.

    abstract::Traumatic injuries to the upper abdominal vasculature pose difficult management problems related to both exposure and associated injuries. Among those injuries that are more difficult to manage are those involving the portal vein. While occurring rarely, portal vein injuries require specific therapeutic considerations...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Mattox KL,Espada R,Beall AR Jr

    更新日期:1975-05-01 00:00:00

  • Implications of Tumor Characteristics and Treatment Modality on Local Recurrence and Functional Outcomes in Children with Chest Wall Sarcoma: A Pediatric Surgical Oncology Research Collaborative Study.

    abstract:OBJECTIVE:To determine the impact of tumor characteristics and treatment approach on (1) local recurrence, (2) scoliosis development and (3) patient-reported quality of life in children with sarcoma of the chest wall. SUMMARY BACKGROUND DATA:Children with chest wall sarcoma require multimodal therapy including chemoth...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Harris CJ,Helenowski I,Murphy AJ,Mansfield SA,LaQuaglia MP,Heaton TE,Cavalli M,Murphy JT,Newman E,Overmen RE,Kartal TT,Cooke-Barber J,Donaher A,Malek MM,Kalsi R,Kim ES,Zobel MJ,Goodhue CJ,Naik-Mathuria BJ,Jefferson

    更新日期:2020-11-04 00:00:00

  • Maintenance of cardiodynamics with aspirin during abdominal aortic aneurysmectomy (AAA).

    abstract::The importance of prostacyclin (PGI2) and thromboxane (Tx) medication of depressed cardiac performance during abdominal aortic aneurysm operative surgery was studied by contrasting the effects of 650 mg aspirin administered 12 hours before operation to that of a placebo. In 11 patients who received a placebo, the stab...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章


    authors: Utsunomiya T,Krausz MM,Dunham B,Mannick JA,Allen PD,Shepro D,Hechtman HB

    更新日期:1981-11-01 00:00:00

  • Living Donor Liver Transplantation in Children: Surgical and Immunological Results in 250 Recipients at Université Catholique de Louvain.

    abstract:OBJECTIVES:To evaluate the outcome of pediatric living donor liver transplantation (LDLT) regarding portal vein (PV) reconstruction, ABO compatibility, and impact of maternal donation on graft acceptance. BACKGROUND:LDLT and ABO-mismatched transplantation constitute feasible options to alleviate organ shortage in chil...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Gurevich M,Guy-Viterbo V,Janssen M,Stephenne X,Smets F,Sokal E,Lefebvre C,Balligand JL,Pirotte T,Veyckemans F,Clapuyt P,Menten R,Dumitriu D,Danse E,Annet L,Clety SC,Detaille T,Latinne D,Sempoux C,Laterre PF,de Mag

    更新日期:2015-12-01 00:00:00

  • Use of fibrin sealant for prosthetic mesh fixation in laparoscopic extraperitoneal inguinal hernia repair.

    abstract:OBJECTIVE:To evaluate the efficacy of mesh fixation with fibrin sealant (FS) in laparoscopic preperitoneal inguinal hernia repair and to compare it with stapled fixation. SUMMARY BACKGROUND DATA:Laparoscopic hernia repair involves the fixation of the prosthetic mesh in the preperitoneal space with staples to avoid dis...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Katkhouda N,Mavor E,Friedlander MH,Mason RJ,Kiyabu M,Grant SW,Achanta K,Kirkman EL,Narayanan K,Essani R

    更新日期:2001-01-01 00:00:00

  • Survival in Locally Advanced Pancreatic Cancer After Neoadjuvant Therapy and Surgical Resection.

    abstract:OBJECTIVE:The aim of the study was to identify the survival of patients with locally advanced pancreatic cancer (LAPC) and assess the effect of surgical resection after neoadjuvant therapy on patient outcomes. BACKGROUND:An increasing number of LAPC patients who respond favorably to neoadjuvant therapy undergo surgica...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Gemenetzis G,Groot VP,Blair AB,Laheru DA,Zheng L,Narang AK,Fishman EK,Hruban RH,Yu J,Burkhart RA,Cameron JL,Weiss MJ,Wolfgang CL,He J

    更新日期:2019-08-01 00:00:00

  • Long-Term Survival After Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Nationwide Propensity-Score Matched Analysis.

    abstract:OBJECTIVES:This study aimed to compare long-term survival following minimally invasive esophagectomy (MIE) versus open esophagectomy (OE) for esophageal cancer using a nationwide propensity-score matched cohort. SUMMARY BACKGROUND DATA:MIE provides lower postoperative morbidity and mortality, and similar short-term on...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kalff MC,Fransen LFC,de Groot EM,Gisbertz SS,Nieuwenhuijzen GAP,Ruurda JP,Verhoeven RHA,Luyer MDP,van Hillegersberg R,van Berge Henegouwen MI,Dutch Upper Gastrointestinal Cancer Audit group.

    更新日期:2020-12-23 00:00:00

  • Outcomes After Multidisciplinary Management of Primary Mediastinal Germ Cell Tumors.

    abstract:OBJECTIVE:We examined management strategies, overall survival (OS), and progression-free survival (PFS) among patients with PMNSGCTs undergoing resection and multidisciplinary management at a high-volume institution. SUMMARY OF BACKGROUND DATA:Outcomes after resection of PMNSGCTs are not well-characterized, with limit...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Caso R,Jones GD,Bains MS,Hsu M,Tan KS,Feldman DR,Funt SA,Reuter VE,Bosl GJ,McHugh D,Huang J,Molena D,Amar D,Fischer G,Rusch VW,Jones DR

    更新日期:2020-01-21 00:00:00

  • Simulation improves resident performance in catheter-based intervention: results of a randomized, controlled study.

    abstract:OBJECTIVES:Surgical simulation has been shown to enhance the training of general surgery residents. Since catheter-based techniques have become an important part of the vascular surgeon's armamentarium, we explored whether simulation might impact the acquisition of catheter skills by surgical residents. METHODS:Twenty...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Chaer RA,Derubertis BG,Lin SC,Bush HL,Karwowski JK,Birk D,Morrissey NJ,Faries PL,McKinsey JF,Kent KC

    更新日期:2006-09-01 00:00:00

  • Impact of Expanded Insurance Coverage on Racial Disparities in Vascular Disease: Insights From Massachusetts.

    abstract:OBJECTIVE:To evaluate the impact of health insurance expansion on racial disparities in severity of peripheral arterial disease. BACKGROUND:Lack of insurance and non-white race are associated with increased severity, increased amputation rates, and decreased revascularization rates in patients with peripheral artery d...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Loehrer AP,Hawkins AT,Auchincloss HG,Song Z,Hutter MM,Patel VI

    更新日期:2016-04-01 00:00:00

  • Modified technique of obturator bypass in failed or infected grafts.

    abstract::The obturator bypass graft operation can be performed in a moderately simplified manner by a technique that allows extension of indications for the procedure beyond situations in which sepsis is present in the groin. Long-term analysis of the results of the cases available for study indicates that the procedure may ve...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Pearce WH,Ricco JB,Yao JS,Flinn WR,Bergan JJ

    更新日期:1983-03-01 00:00:00

  • Prospective study of eukaryotic initiation factor 4E protein elevation and breast cancer outcome.

    abstract:OBJECTIVE:To validate the authors' initial hypothesis-generating observation that eukaryotic initiation factor 4E (eIF4E) protein elevation predicts a higher cancer recurrence rate in patients with stage 1 to 3 breast cancer. SUMMARY BACKGROUND DATA:Tumor size and nodal status continue to be the two most important ind...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Li BD,Gruner JS,Abreo F,Johnson LW,Yu H,Nawas S,McDonald JC,DeBenedetti A

    更新日期:2002-05-01 00:00:00

  • Surgical aspects in the treatment of patients with unilateral wilms tumor: a report from the SIOP 93-01/German Society of Pediatric Oncology and Hematology.

    abstract:OBJECTIVE:To assess surgical aspects in the treatment of children with unilateral Wilms tumor based on data from the Cooperative Tumor Study SIOP 93-01 of the German Society of Pediatric Hematology and Oncology. SUMMARY BACKGROUND DATA:Although multiple international study trials exist for the treatment of nephroblast...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Fuchs J,Kienecker K,Furtwängler R,Warmann SW,Bürger D,Thürhoff JW,Hager J,Graf N

    更新日期:2009-04-01 00:00:00

  • Artesunate Protects Against the Organ Injury and Dysfunction Induced by Severe Hemorrhage and Resuscitation.

    abstract:OBJECTIVE:To evaluate the effects of artesunate on organ injury and dysfunction associated with hemorrhagic shock (HS) in the rat. BACKGROUND:HS is still a common cause of death in severely injured patients and is characterized by impairment of organ perfusion, systemic inflammatory response, and multiple organ failur...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Sordi R,Nandra KK,Chiazza F,Johnson FL,Cabrera CP,Torrance HD,Yamada N,Patel NS,Barnes MR,Brohi K,Collino M,Thiemermann C

    更新日期:2017-02-01 00:00:00

  • Computerized nuclear morphometry: a new morphologic assessment for advanced gastric adenocarcinoma.

    abstract:OBJECTIVE:To evaluate the correlation between the morphologic nuclear features and clinicopathologic parameters in patients with advanced gastric cancer. SUMMARY BACKGROUND DATA:Nuclear profiles have been reported as useful prognostic predictors in various cancers. Data from computerized morphometries are objective an...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Ikeguchi M,Oka S,Saito H,Kondo A,Tsujitani S,Maeta M,Kaibara N

    更新日期:1999-01-01 00:00:00

  • Isolated limb perfusion with tumor necrosis factor and melphalan for limb salvage in 186 patients with locally advanced soft tissue extremity sarcomas. The cumulative multicenter European experience.

    abstract:OBJECTIVE:The objective of the study was to achieve limb salvage in patients with locally advanced soft tissue sarcomas that can only be treated by amputation or functionally mutilating surgery by performing an isolated limb perfusion (ILP) with tumor necrosis factor (TNF) + melphalan (M) as induction biochemotherapy t...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Eggermont AM,Schraffordt Koops H,Klausner JM,Kroon BB,Schlag PM,Liénard D,van Geel AN,Hoekstra HJ,Meller I,Nieweg OE,Kettelhack C,Ben-Ari G,Pector JC,Lejeune FJ

    更新日期:1996-12-01 00:00:00

  • Depressed high-energy phosphate content in hypertrophied ventricles of animal and man: the biologic basis for increased sensitivity to ischemic injury.

    abstract::It is frequently stated that hypertrophied ventricles tolerate ischemia less well than nonhypertrophied ventricles. The authors' earlier studies in a rat supravalvular aortic stenosis model and canine valvular aortic stenosis model, both with concentric left ventricular hypertrophy, disclosed accelerated rates of isch...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Peyton RB,Jones RN,Attarian D,Sink JD,Van Trigt P,Currie WD,Wechsler AS

    更新日期:1982-09-01 00:00:00

  • Analysis of injury in complex organ preservation.

    abstract::A biochemical assay of renal viability previously described for rabbits is validated in a canine model using anoxia, hypothermia, and hypothermic perfusion. The assay correlated well with the decree of anoxic injury and protective effect of hypothermia. It was found to be unable to document significant injury when pul...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Weinerth JL,Abbott WM

    更新日期:1974-12-01 00:00:00

  • Failure-to-pursue rescue: explaining excess mortality in elderly emergency general surgical patients with preexisting "do-not-resuscitate" orders.

    abstract:OBJECTIVE:To describe the outcomes of elderly patients with do-not-resuscitate (DNR) status who undergo emergency general surgery and to improve understanding of the relationship between preoperative DNR status and postoperative mortality. BACKGROUND:Preoperative DNR status has previously been shown to predict increas...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Scarborough JE,Pappas TN,Bennett KM,Lagoo-Deenadayalan S

    更新日期:2012-09-01 00:00:00

  • Impaired nonspecific cellular immunity in experimental cholestasis.

    abstract::The abilities of polymorphonuclear leukocytes (PMN) and pulmonary alveolar macrophages (PAM), to demonstrate chemotaxis, phagocytosis, and superoxide release after bile duct ligation in the rat were investigated to determine the effect of cholestasis on nonspecific cellular immune mechanisms. Chemotactic response to C...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Roughneen PT,Drath DB,Kulkarni AD,Rowlands BJ

    更新日期:1987-11-01 00:00:00

  • Derivation and Validation of a Generalizable Preoperative Frailty Index Using Population-based Health Administrative Data.

    abstract:OBJECTIVE:To develop and validate a preoperative frailty index (pFI) for use in population-based health administrative (HA) data. SUMMARY BACKGROUND DATA:Frailty is a robust predictor of adverse postoperative outcomes. Population-level frailty measures used in surgical studies have significant methodological limitatio...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: McIsaac DI,Wong CA,Huang A,Moloo H,van Walraven C

    更新日期:2019-07-01 00:00:00

  • SM22 a Plasma Biomarker for Human Transmural Intestinal Ischemia.

    abstract:OBJECTIVE:To evaluate the diagnostic potential of smooth muscle protein of 22 kDa (SM22) as plasma biomarker for the detection of transmural intestinal ischemia. BACKGROUND:Acute mesenteric ischemia is an abdominal emergency requiring rapid diagnosis and treatment. Especially, detection of transmural damage is imperat...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Schellekens DHSM,Reisinger KW,Lenaerts K,Hadfoune M,Olde Damink SW,Buurman WA,Dejong CHC,Derikx JPM

    更新日期:2018-07-01 00:00:00

  • 250 robotic pancreatic resections: safety and feasibility.

    abstract:BACKGROUND AND OBJECTIVES:Computer-assisted robotic surgery allows complex resections and anastomotic reconstructions to be performed with nearly identical standards to open surgery. We applied this technology to a variety of pancreatic resections to assess the safety, feasibility, versatility, and reliability of this ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Zureikat AH,Moser AJ,Boone BA,Bartlett DL,Zenati M,Zeh HJ 3rd

    更新日期:2013-10-01 00:00:00

  • Effect of prolonged selective intramesenteric arterial vasodilator therapy on intestinal viability after acute segmental mesenteric vascular occlusion.

    abstract:OBJECTIVE:To evaluate the effect of selective intramesenteric artery vasodilator infusion on intestinal viability in a rat model of acute segmental mesenteric vascular occlusion. SUMMARY BACKGROUND DATA:Although intramesenteric arterial vasodilator infusion may be an effective treatment for nonocclusive mesenteric isc...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Meilahn JE,Morris JB,Ceppa EP,Bulkley GB

    更新日期:2001-07-01 00:00:00

  • Prognostic Value of a Four-miRNA Signature in Patients with Lymph Node Positive Locoregional Esophageal Squamous Cell Carcinoma Undergoing Complete Surgical Resection.

    abstract:OBJECTIVE:This study was intended to identify prognostic biomarkers for lymph node (LN)-positive locoregional esophageal squamous cell carcinoma (ESCC) patients. SUMMARY OF BACKGROUND DATA:Surgery is a major treatment for LN-positive locoregional ESCC patients in China. However, patient outcomes are poor and heterogen...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Wen J,Wang G,Xie X,Lin G,Yang H,Luo K,Liu Q,Ling Y,Xie X,Lin P,Chen Y,Zhang H,Rong T,Fu J

    更新日期:2019-04-30 00:00:00

  • Endovascular repair of abdominal aortic aneurysms: risk stratified outcomes.

    abstract:OBJECTIVE:The impact of co-morbid conditions on early and late clinical outcomes after endovascular treatment of abdominal aortic aneurysm (AAA) was assessed in concurrent cohorts of patients stratified with respect to risk for intervention. SUMMARY BACKGROUND DATA:As a minimally invasive strategy for the treatment of...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Chaikof EL,Lin PH,Brinkman WT,Dodson TF,Weiss VJ,Lumsden AB,Terramani TT,Najibi S,Bush RL,Salam AA,Smith RB 3rd

    更新日期:2002-06-01 00:00:00

  • The Linton splenorenal shunt in the management of the bleeding complications of portal hypertension.

    abstract::This report describes 140 cases in which Linton splenorenal shunts were performed for the management of the complications of portal hypertension by a large number of surgeons in a single hospital. There was a history of variceal bleeding in 130. Using the Childs designation to reflect hepatic functional reserve, the o...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Ottinger LW

    更新日期:1982-12-01 00:00:00

  • Tumor-infiltrating Neutrophils is Prognostic and Predictive for Postoperative Adjuvant Chemotherapy Benefit in Patients With Gastric Cancer.

    abstract:OBJECTIVE:This study was aimed to investigate the prognostic value of tumor-infiltrating neutrophils (TINs) and to generate a predictive model to refine postoperative risk stratification system for patients with gastric cancer. BACKGROUND:TIN presents in various malignant tumors, but its clinical significance in gastr...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Zhang H,Liu H,Shen Z,Lin C,Wang X,Qin J,Qin X,Xu J,Sun Y

    更新日期:2018-02-01 00:00:00

  • Minimal access retroperitoneal pancreatic necrosectomy: improvement in morbidity and mortality with a less invasive approach.

    abstract:OBJECTIVE:Comparison of minimal access retroperitoneal pancreatic necrosectomy (MARPN) versus open necrosectomy in the treatment of infected or nonresolving pancreatic necrosis. SUMMARY OF BACKGROUND DATA:Infected pancreatic necrosis may lead to progressive organ failure and death. Minimal access techniques have been ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Raraty MG,Halloran CM,Dodd S,Ghaneh P,Connor S,Evans J,Sutton R,Neoptolemos JP

    更新日期:2010-05-01 00:00:00

  • Women Surgeons' Perspectives on System-level Strategies to Address Interpersonal Workplace Conflict.

    abstract:OBJECTIVE:We sought to gain a comprehensive understanding of the current methods for conflict resolution and the ways in which women surgeons would prefer workplace conflicts to be adjudicated. SUMMARY OF BACKGROUND DATA:Interprofessional workplace conflicts are poorly studied, particularly for women in surgery. These...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lindquist KM,Vitous CA,Dossett LA,Jagsi R,Telem DA

    更新日期:2020-07-07 00:00:00