The following is a summary of “Transurethral Resection of Bladder Tumor Outcomes are Predicted by a 5-item Frailty Index,” published in the March issue of Urology by Connors et al.

This study aimed to assess the predictive capacity of the modified Frailty Index with five items (mFI-5) in anticipating post-operative outcomes after transurethral resection of bladder tumor (TURBT). Utilizing data from the National Surgical Quality Improvement Program spanning from 2015 to 2019, researchers identified 40,278 TURBT cases. mFI-5 scores were determined by assigning points for chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), dependent functional status, hypertension, and diabetes. 

Patients were categorized based on their mFI-5 scores, and demographic characteristics along with 30-day outcomes, including Clavien-Dindo (CD) complications, mortality, and heightened healthcare resource utilization (HCRU), were analyzed. HCRU outcomes encompassed prolonged length of stay (PLOS), unplanned readmission (UR), and discharge to continued care (DCC). Multivariate regression analysis was employed to evaluate the predictive value of mFI-5 scores on outcomes. Results revealed a clear association between higher mFI-5 scores and older age, male gender, White ethnicity, and larger tumor sizes. 

Furthermore, escalating mFI-5 scores correlated with heightened frequencies of adverse outcomes. Multivariate analysis confirmed that an mFI-5 score of ≥3 significantly predicted CD I/II complications, CD IV complications, mortality, HCRU, PLOS, DCC, and UR. Notably, an mFI-5 score of ≥3 exhibited sensitivity ranging from 6.0% to 13.5% and specificity ranging from 96.6% to 97.0% across all outcomes. In conclusion, the MFI-5 is a readily accessible pre-operative risk assessment tool that effectively predicts adverse clinical outcomes and heightened healthcare resource utilization following TURBT.

Source: sciencedirect.com/science/article/abs/pii/S0090429524002012