Does the 5-item Frailty Index predict surgical complications of endoscopic surgical management for benign prostatic obstruction? An analysis of the ACS-NSQIP

Labban, Muhieddine; Frego, Nicola; Qian, Zhiyu; Nguyen, David‐Dan; Chen, Chang-Rong; Berk, Brittany D; Lipsitz, Stuart R.; Bhojani, Naeem; Kathrins, Martin; Trinh, Quoc‐Dien

doi:10.1007/s00345-022-04151-8

Cited by 6 publications

(2 citation statements)

References 28 publications

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“…The frailty score involves multiple factors to evaluate surgical risk rather simple consideration of age or comorbidities. (18,19) In the current study, the frailty score was significantly higher in the octogenarian and nonagenarian patients however 83% of this group had frailty score of 0 or 1. This emphasizes that the proper preoperative screening and assessment of the patients' general condition and performance status is paramount and is better than simple consideration of age.…”

Section: Discussioncontrasting

confidence: 42%

Holmium laser enucleation of prostate (HoLEP) in nonagenarians and octogenarians

Elsaqa

Zhang

Tayeb

2023

CUAJ

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Introduction: Holmium laser enucleation of the prostate (HoLEP) is a well-established technique for management of benign prostatic hyperplasia (BPH). With the growing aging population, a considerable percentage of octogenarians (80–90 years old) and nonagenarians (>90 years old) require surgical management for BPH. We aimed to assess the outcomes of HoLEP in those age groups. Methods: We reviewed a maintained database for HoLEP patients in a tertiary center. Patients were assigned to two groups: above (group A) and below (group B) 80 years old. Perioperative outcome and postoperative followup data were compared between both groups. Results: The study included 1090 patients, 201 and 889 in groups A and B, respectively. Median age was 83 and 70 years in groups A and B, respectively. Group A showed longer operative time, longer catheterization time, and higher 30-day emergency room visits and readmission rates. Hemoglobin drop was comparable, although associated with higher rate of blood transfusion in group A. Overall, 30-day postoperative complications were higher in group A (20.8% vs, 9.3%, p= 0.008), although the majority of complications in both groups were grade I and II. The rate of complications over Clavien-Dindo grade II were statistically comparable (3.4% vs. 1.79%, p= 0.133). Followup at six weeks, three months, and one year showed comparable functional outcomes in both groups. Conclusions: HoLEP is a safe and effective option in the geriatric population of octogenarians and even nonagenarians. HoLEP is associated with higher overall complication rate in older age groups; however, most complications were minor.

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Section: Discussioncontrasting

confidence: 42%

Holmium laser enucleation of prostate (HoLEP) in nonagenarians and octogenarians

Elsaqa

Zhang

Tayeb

2023

CUAJ

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“…Eredics et al, in 2020, registered no difference in intraoperative and perioperative complications, TWOC, and LOS between fit and frail patients [ 26 ]. However, Labban et al found the five-item Frailty Index, a geriatric assessment tool, to be associated with all types of complications (OR 1.50), LOS (OR 1.31), and readmission rates (OR 1.65) after different types of endoscopic BPO surgeries [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Functional Outcome and Safety of Endoscopic Treatment Options for Benign Prostatic Obstruction (BPO) in Patients ≥ 75 Years of Age

Deininger,

Dieplinger,

Lauth

et al. 2024

JCM

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Background: The selection of suitable patients for the surgical treatment of benign prostatic obstruction (BPO) is a challenge in persons ≥75 years of age. Methods: After a systematic literature search of PubMed, 22 articles were included in this review. Clinical and functional parameters were evaluated statistically. Results: The mean age of the patients was ≥79 years. The mean duration of postoperative catheterization ranged between 2 (d) (ThuLEP, thulium laser enucleation of the prostate) and 4.4 days (TURP, transurethral resection of the prostate). Complication rates ranged between 6% (HoLAP, holmium laser ablation of the prostate) and 34% (PVP, photoselective vaporization of the prostate); the maximum rate of severe complications was 4% (TURP). The mean postoperative maximal urinary flow (Qmax) in mL/sec. ranged between 12.9 mL/sec. (HoLAP) and 19.8 mL/sec (Hol-TUIP, holmium laser transurethral incision of the prostate). The mean quality of life (QoL) score fell from 4.7 ± 0.9 to 1.8 ± 0.7 (HoLEP), from 4.1 ± 0.4 to 1.9 ± 0.8 (PVP), from 5.1 ± 0.2 to 2.1 ± 0.2 (TURP), and from 4 to 1 (ThuVEP, thulium laser vapoenucleation of the prostate). Pearson’s correlation coefficient (r) revealed a positive linear correlation between age and inferior functional outcome (higher postoperative International Prostate Symptom Score (IPSS) [r = 0.4175]), higher overall complication rates (r = 0.5432), and blood transfusions (r = 0.4474) across all surgical techniques. Conclusions: This meta-analysis provides the summary estimates for perioperative and postoperative functional outcome and safety of endoscopic treatment options for BPO in patients ≥ 75 years of age. Of particular importance is that all surgical techniques significantly improve the postoperative quality of life of patients in this age group compared to their preoperative quality of life.

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Extraperitoneal Single Port vs Transperitoneal Multiport Robot assisted radical prostatectomy in frail patients: A propensity score matched comparative analysis

Lambertini,

Pacini,

Calvo

et al. 2024

European Journal of Surgical Oncology

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Does the 5-item Frailty Index predict surgical complications of endoscopic surgical management for benign prostatic obstruction? An analysis of the ACS-NSQIP

Cited by 6 publications

References 28 publications

Holmium laser enucleation of prostate (HoLEP) in nonagenarians and octogenarians

Holmium laser enucleation of prostate (HoLEP) in nonagenarians and octogenarians

Functional Outcome and Safety of Endoscopic Treatment Options for Benign Prostatic Obstruction (BPO) in Patients ≥ 75 Years of Age

Extraperitoneal Single Port vs Transperitoneal Multiport Robot assisted radical prostatectomy in frail patients: A propensity score matched comparative analysis

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