Application: 507

THE RISK ANALYSIS FRAILTY INDEX OUTPERFORMS THE NSQIP FRAILTY INDEX IN PREDICTING RISK FOR
PATIENTS UNDERGOING SACROCOLPOPEXY

Started at: 10/5/2022 01:47 PM - Finalized at: 10/6/2022 08:44 PM

Page: Applicant Information

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First Name
Kerith

Last Name
Wang

Email Address
[Link]@[Link]

Page: Abstract Info

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Abstract Title
THE RISK ANALYSIS FRAILTY INDEX OUTPERFORMS THE NSQIP FRAILTY INDEX IN PREDICTING RISK FOR PATIENTS UNDERGOING
SACROCOLPOPEXY

Type of Presentation
Abstract

Abstract Categories
Pelvic Organ Prolapse

Table(s), Graph(s) or Illustration(s)

Download File ([Link]
[Link]/file/611/eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJtZWRpYUlkIjo2MTEsImFsbG93Tm90U2lnbmVkVXJsIjoiRmFsc2UiLCJpZ25vcmVPcGVu
C0b5gvr-K9nWWmorBcCZaktrnNrON7JiZqD1Tag?SCP%20Risk%[Link])

Introduction/Background
Sacrocolpopexy (SCP) is a definitive treatment option for pelvic organ prolapse (POP). Because there are less invasive, albeit less definitive
treatment options, a frailty index that best predicts outcomes and mortality for patients desiring SCP is useful to aid in decision making.

Methods/Materials
Open and minimally invasive SCPs performed from 2006 to 2020 were identified in ​the American College of Surgeons’ National Surgical Quality
Improvement Program (NSQIP) database. Frailty was calculated using the NSQIP modified frailty index (mFI-5), a previously validated 5-item
score including points for diabetes, impaired functional status, COPD, CHF, and hypertension, and the revised surgical Risk Analysis Index (RAI-
rev), a validated score which accounts for patient comorbidities, age, and functional status. As previously published, patients with mFI-5 scores of
2 or more and RAI-rev scores of 26 or more were considered “frail.” Univariate logistic regression and t-test analyses were performed to apply
mFI-5 and RAI-rev as predictors of surgical complications, 30-day readmissions, 30-day mortality, and hospital length of stay (LOS). All p-values
were two-tailed, with p<0.05 considered statistically significant.

Results
9,082 SCPs were identified in the database. In total, 5.2% of patients experienced minor complications (superficial SSIs, pneumonia, UTIs,
bleeding requiring transfusion, or AKIs), and 1.4% of patients experienced major complications (sepsis, DVT, stroke, reintubation, renal failure,
myocardial infarction, pulmonary embolism, septic shock, wound dehiscence, deep wound infections, or cardiac arrest). The 30-day readmission
and mortality rates were 2.7% and 0.02%, respectively. On univariate logistic regression, a frail mFI-5 score was not predictive of minor
complications, major complications, 30-day readmissions or mortality. However, a frail compared to a non-frail mFI-5 was associated with a higher
LOS (1.6 vs 1.4, p=.008). A frail compared to a non-frail RAI-rev was predictive of major complications [OR 2.52; 95%CI 1.34-4.72; p=0.004],
30-day readmissions [OR 2.62, 95%CI 1.61-4.26; p=.0001], 30-day mortality [OR 26.8; 95%CI 1.67-428.88; p=0.02], and LOS (1.8 vs 1.4
days, p=.0008).
Conclusions
The RAI-rev is a better predictor than the mFI-5 for major complications, readmission rate, mortality, and hospital LOS and may help in the
decision making and risk counseling for patients POP considering an SCP.

Funding
None

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Please add the name, address, phone and email of the Presenting author, including their educational background and current position.

First Name
Kerith

Last Name
Wang

Email Address
[Link]@[Link]

Title/Designation

Institution/Affiliation
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA

Best Contact Phone Number

Address
1025 Walnut St. Suite 1112
Philadelphia Pennsylvania 19107 US

I am a Resident
No
Additional Lead Authors
Rishabh Simhal,
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University

Kerith Wang,
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University

Maria D'Amico, MD
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University

Courtney Capella, MD
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University

Radhika Ragam, MD
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University

Joonyau Leong, MD
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University

Yash Shah,
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University

Mihir Shah, MD
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University

Patrick Shenot, MD
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University

Alana Murphy, MD
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University

Co-Authors

Page: Disclosure

The presenting author must complete a disclosure form

I am the presenting author

First Name
Kerith

Last Name
Wang

Email Address
[Link]@[Link]
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Kerith Wang

Date
10/5/2022
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