학술논문

The Impact of Frailty on Artificial Urinary Sphincter Placement and Removal Procedures.
Document Type
article
Source
Subject
Humans
Urinary Incontinence
Stress
Postoperative Complications
Device Removal
Urologic Surgical Procedures
Incidence
Retrospective Studies
Follow-Up Studies
Urinary Sphincter
Artificial
Aged
Aged
80 and over
United States
Female
Male
Frailty
Patient Safety
Clinical Research
Clinical Sciences
Urology & Nephrology
Language
Abstract
ObjectiveTo determine whether frailty is associated with increased odds of 30-day surgical complications among men undergoing both artificial urinary sphincter (AUS) placement and removal procedures and to determine whether frailty was associated with increased odds of having an AUS removal procedure.MethodsThis is a retrospective cohort study of men undergoing AUS placement and removal procedures using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2006 to 2013. Frailty was quantified using the NSQIP-FI (frailty index) and was applied to logistic regression models predicting 30-day complications (overall, major, and minor) and the odds of having an AUS removal procedure (over an AUS placement procedure).ResultsWe identified a total of 624 and 147 men undergoing AUS placement and removal procedures, respectively. NSQIP-FI of ≥0.27, but not age, was associated with major complications (aOR 3.5, 95% confidence interval 1.2-9.9), while age ≥85 years, but not NSQIP-FI, was associated with minor complications (aOR 7.9, 95% confidence interval 1.4-45.6). Men undergoing AUS removal procedures tended to be more frail compared to men undergoing AUS placement procedures (12.9% vs 6.1% had NSQIP-FI of ≥0.27, P