SynthesisBJU international2021
Implementation of frailty preoperative assessment to predict outcome in patients undergoing urological surgery: a systematic review and meta-analysis.
Synthesis in BJU international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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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.
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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.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Impact of frailty on overall survival and complications in patients with prostate cancer: a systematic review and meta-analysis.International urology and nephrology · 2026Pooled it
- Impact of frailty on adverse outcomes after radical cystectomy: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Association of preoperative frailty with health-related quality of life and urinary function after robot-assisted radical prostatectomy.Translational andrology and urology · 2026Article
- Comorbidities in Age-Related Cataract: Epidemiological Burden and Public Health Implications.Vision (Basel, Switzerland) · 2026Review
- Frailty: from concept to clinical practice in urology.Frontiers in medicine · 2026Review
- Assessing frailty to predict surgical risk: a comparative study of three tools in older non-cardiac surgery patients.BMC geriatrics · 2025Article
- Transurethral resection of the prostate in the extreme elderly (≥ 85 years): treatment success, morbidity and survival.World journal of urology · 2025Article
- The Implementation of Frailty Assessment Tools in the Acute Care Setting: A Scoping Review.Journal of the American Geriatrics Society · 2025Article
- The perioperative frailty index derived from the Chinese hospital information system: a validation study.BMC geriatrics · 2024Article
- Preoperative frailty predicts postoperative pain after total knee arthroplasty in older patients: a prospective observational study.European geriatric medicine · 2024Observational
- Diagnosis of frailty and implications on surgical process in the elderly: A narrative review.European journal of anaesthesiology and intensive care · 2023Review
- Can the Modified Frailty Index (mFI) Predict Intraoperative and Postoperative Complications in Older Women with Endometrial Cancer Undergoing Laparoscopic or Robotic Surgery? A Multicenter Observational Study.Journal of clinical medicine · 2023Article
- Prognostic value of 11-factor modified frailty index in postoperative adverse outcomes of elderly gastric cancer patients in China.World journal of gastrointestinal surgery · 2023Article
- Article
- Prevalence and adverse outcomes of pre-operative frailty in patients undergoing carotid artery revascularization: a meta-analysis.Frontiers in cardiovascular medicine · 2023Review
- Frailty scoring systems in urological surgery: Current status and future perspectives.Urology annalsReview
Corrections and comments
- Commented on byGeriatrics.2021
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA common limit of the widely used risk scores for preoperative assessment is the lack of information about aspects linked to frailty that may affect outcome, especially in the setting of elderly patients undergoing urological surgery. Frailty has recently been introduced as an additional characteristic to be assessed for better identifying patients at risk of negative outcomes.
objectiveTo examine the evidence for recent advances in preoperative assessment in patients undergoing urological surgery focussing on the detrimental effect of frailty on outcome, including major (mPCs) and total postoperative complications (tPCs), discharge to a facility, and mortality. The secondary aim was to establish which cut-off scores of the modified Frailty Index (mFI, 11 items) and/or simplified FI (sFI, five items) predicted PCs.
methodsWe searched PubMed, the Excerpta Medica database (EMBASE), Cochrane Library and clinicaltrial.gov from inception to 31 May 2020. Studies reporting relationships between the investigated outcomes and patients' frailty were included. We estimated odds ratios (ORs) through a random effect model by using Revman 5.4.
resultsFrailty, assessed by different tools, was associated with a significantly higher rate of 30-day (OR 1.73, 95% confidence interval [CI] 1.58-1.89) and 90-day (OR 2.09, 95% CI 1.14-3.82) mPCs and 30-day tPCs (OR 2.10, 95% CI 1.76-2.52). A mFI of ≥2 was associated with a higher rate of 30-day mPCs (OR 1.79, 95% CI 1.69-1.89) and greater 30-day mortality (OR 3.46, 95% CI 2.10-5.49). A pre-planned post hoc analysis also revealed that a sFI of ≥3 was predictive of mPCs (OR 3.30, 95% CI 2.12-5.12).
conclusionsFrailty assessment may help to predict PCs and mortality in patients undergoing major urological surgery. Either a mFi of ≥2 or sFI of ≥3 should be considered potential 'red flags' for preoperative risk assessment and decision-making. There is not enough evidence to confirm the necessity to perform frailty assessment in minor urological surgery.
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