Evidence map›Paper›PMID 26899289›Full record

ArticleUrologic oncology2016

Frailty as a marker of adverse outcomes in patients with bladder cancer undergoing radical cystectomy.

Meera R Chappidi, Max Kates, Hiten D Patel, Jeffrey J Tosoian, Deborah R Kaye, Nikolai A Sopko, Danny Lascano, Jen-Jane Liu, James McKiernan, Trinity J Bivalacqua

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Urologic oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 2 pooled it
13.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 2 syntheses or guidelines pooled it, 126 citations in OpenAlex.

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  9. Frailty and nutritional status predict postoperative complications in radical cystectomy patients.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Meera R ChappidiThe James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD. Electronic address: mchappi1@jhmi.edu.
Max KatesThe James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
Hiten D PatelThe James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
Jeffrey J TosoianThe James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
Deborah R KayeThe James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
Nikolai A SopkoThe James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
Danny LascanoDepartment of Urology, Herbert Irving Cancer Center, Columbia University College of Physicians and Surgeons, New York, NY.
Jen-Jane LiuThe James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
James McKiernanDepartment of Urology, Herbert Irving Cancer Center, Columbia University College of Physicians and Surgeons, New York, NY.
Trinity J BivalacquaThe James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
Johns Hopkins University · USColumbia University · US

Funding

Institute for Clinical and Translational ResearchTL1TR001078 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$1.9M
NCATS NIH HHS TL1 TR001078
6 · The paper itself

Abstract

objectiveTo investigate the modified frailty index (mFI) as a preoperative predictor of postoperative complications following radical cystectomy (RC) in patients with bladder cancer. MATERIALS AND

methodsPatients undergoing RC were identified from the National Surgical Quality Improvement Program participant use files (2011-2013). The mFI was defined in prior studies with 11 variables based on mapping the Canadian Study of Health and Aging Frailty Index to the National Surgical Quality Improvement Program comorbidities and activities of daily livings. The mFI groups were determined by the number of risk factors per patient (0, 1, 2, and≥3). Univariable and multivariable regression were performed to determine predictors of Clavien 4 and 5 complications, and a sensitivity analysis was performed to determine the mFI value that would be a significant predictor of Clavien 4 and 5 complications.

resultsOf the 2,679 cystectomy patients identified, 843 (31%) of patients had an mFI of 0, 1176 (44%) had an mFI of 1, 555 (21%) had an mFI of 2, and 105 (4%) had an mFI≥3. Overall, 1585 (59%) of patients experienced a Clavien complication. When stratified at a cutoff of mFI≥2, the overall complication rate was not different (61.7% vs. 58.3%, P = 0.1), but the mFI2 or greater group had a significantly higher rate of Clavien grade 4 or 5 complications (14.6% vs. 8.3%, P<0.001) and overall mortality rate (3.5% vs. 1.8%, P = 0.01) in the 30-day postoperative period. The multivariate logistic regression model showed independent predictors of Clavien grade 4 or 5 complications were age>80 years (odds ratio [OR] = 1.58 [1.11-2.27]), mFI2 (OR = 1.84 [1.28-2.64]), and mFI3 (OR = 2.58 [1.47-4.55]).

conclusionsAmong patients undergoing RC, the mFI can identify those patients at greatest risk for severe complications and mortality. Given that bladder cancer is increasing in prevalence particularly among the elderly, preoperative risk stratification is crucial to inform decision-making about surgical candidacy.

Indexed as

AgedAged, 80 and overCanadaCystectomyFemaleFrailtyHumansMaleMiddle AgedPostoperative ComplicationsQuality ImprovementRetrospective StudiesRisk AssessmentUrinary Bladder NeoplasmsBladder cancerFrailtyPerioperative outcomesRadical cystectomy

Identifiers

PMID26899289
PMCPMC4875870
OpenAlexW2276379184

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.