Evidence map›Paper›PMID 40172613›Full record

ArticleInternational urology and nephrology2025

Frailty and surgical outcomes in genitourinary prosthetic procedures: an ACS-NSQIP comparative analysis of risk indices.

Umar Ghaffar, Behzad Abbasi, Nizar Hakam, Adrian Fernandez, Marvin N Carlisle, Robert Pearce, Hiren V Patel, Kevin D Li, Nikit Venishetty, Benjamin N Breyer

Abstract readComparative Study
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In one paragraph

Article in International urology and nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

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3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Umar GhaffarDepartment of Urology, University of California San Francisco, 400 Parnassus Ave, A632, Box 0738, San Francisco, CA, 94143, USA.
Behzad AbbasiDepartment of Urology, University of California San Francisco, 400 Parnassus Ave, A632, Box 0738, San Francisco, CA, 94143, USA.
Nizar HakamDepartment of Urology, University of California San Francisco, 400 Parnassus Ave, A632, Box 0738, San Francisco, CA, 94143, USA.
Adrian FernandezDepartment of Urology, University of California San Francisco, 400 Parnassus Ave, A632, Box 0738, San Francisco, CA, 94143, USA.
Marvin N CarlisleDepartment of Urology, University of California San Francisco, 400 Parnassus Ave, A632, Box 0738, San Francisco, CA, 94143, USA.
Robert PearceDepartment of Urology, University of California San Francisco, 400 Parnassus Ave, A632, Box 0738, San Francisco, CA, 94143, USA.
Hiren V PatelDepartment of Urology, University of California San Francisco, 400 Parnassus Ave, A632, Box 0738, San Francisco, CA, 94143, USA.
Kevin D LiDepartment of Urology, University of California San Francisco, 400 Parnassus Ave, A632, Box 0738, San Francisco, CA, 94143, USA.
Nikit VenishettyPaul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.
Benjamin N BreyerDepartment of Urology, University of California San Francisco, 400 Parnassus Ave, A632, Box 0738, San Francisco, CA, 94143, USA. Benjamin.Breyer@ucsf.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the association between frailty and surgical outcomes using frailty indices and to assess tool performance. Genitourinary prosthetics, including artificial urinary sphincter (AUS), urethral sling, and penile prosthesis, are standard therapeutic interventions but are susceptible to complications. These procedures are often performed on older, frail patients, necessitating a deeper understanding of the relationship between frailty and postoperative morbidity.

methodsWe utilized data from the NSQIP database (2011-2020) to identify patients undergoing urologic prosthetic procedures, including artificial urinary sphincter, sling, and penile prosthesis. Frailty was assessed using the modified frailty index-5 (mFI-5), the Risk Analysis Index (RAI-A) and ASA Class. Primary outcomes focused on 30-day postoperative morbidity, with secondary outcomes including mortality, length of stay, discharge disposition, readmissions, and reoperations. Logistic and linear regression models were constructed, adjusting for relevant clinical variables, and ROC curve plotted to compare the predictive abilities of mFI-5, RAI-A, and ASA classification.

resultsWe identified 4,734 patients who underwent AUS, sling, or penile prosthesis surgeries. Frailty, as measured by RAI-A (OR 2.05, 95% CI 1.59-2.65, p < 0.001) and ASA Class (OR 1.55, 95% CI 1.19-2.01, p = 0.001), was significantly associated with postoperative morbidity, while mFI-5 was not. Cardiovascular complications and discharge to continued care were associated with all tools. ROC curve analysis showed that RAI-A had significantly greater predictive ability for postoperative morbidity than mFI-5 (p = 0.023).

conclusionsRAI-A and ASA are more effective than the mFI-5 in predicting postoperative morbidity, mortality, and other adverse outcomes in patients undergoing urologic prosthetic surgeries.

Indexed as

FrailtyPenile ProsthesisPostoperative ComplicationsSuburethral SlingsUrinary Sphincter, ArtificialAgedAged, 80 and overDatabases, FactualFemaleHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentTreatment OutcomeArtificial Urinary SphincterFrailtyPenile ProsthesisUrethral SlingUrologic Prosthetics

Identifiers

PMID40172613

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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.