Evidence map›Paper›PMID 40214944›Full record

ArticleJournal of robotic surgery2025

Frailty index and nutrition status impact perioperative outcomes in patients undergoing minimally invasive radical nephrectomy.

David E Hinojosa-Gonzalez, Gal Saffati, Gustavo Salgado-Garza, Cecilio Armengol Garcia, Madeline Chaput, Benjamin Yu, Lauren Miranda-Abghary, Sienna Blackwell, Jeremy R Slawin, Wesley A Mayer

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Article in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
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.

David E Hinojosa-GonzalezScott Department of Urology, Baylor College of Medicine, 7200 Cambridge St, Houston, TX, USA. david.hinojosa-gonzalez@bcm.edu.ORCID http://orcid.org/0000-0002-0233-0607
Gal SaffatiScott Department of Urology, Baylor College of Medicine, 7200 Cambridge St, Houston, TX, USA.ORCID http://orcid.org/0009-0005-3053-5828
Gustavo Salgado-GarzaDepartment of Surgery, Oregon Health & Science University, Portland, OR, USA.ORCID http://orcid.org/0000-0002-6696-4043
Cecilio Armengol GarciaTecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico.
Madeline ChaputScott Department of Urology, Baylor College of Medicine, 7200 Cambridge St, Houston, TX, USA.
Benjamin YuScott Department of Urology, Baylor College of Medicine, 7200 Cambridge St, Houston, TX, USA.
Lauren Miranda-AbgharyMichael E DeBakey VA Medical Center, Houston, TX, USA.
Sienna BlackwellScott Department of Urology, Baylor College of Medicine, 7200 Cambridge St, Houston, TX, USA.
Jeremy R SlawinScott Department of Urology, Baylor College of Medicine, 7200 Cambridge St, Houston, TX, USA.
Wesley A MayerScott Department of Urology, Baylor College of Medicine, 7200 Cambridge St, Houston, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Frailty and malnutrition are recognized risk factors for poor surgical outcomes, yet their specific impact on perioperative outcomes in patients undergoing minimally invasive radical nephrectomy (RN) remains underexplored. This study aims to evaluate how frailty, as measured by the Modified 5-Item Frailty Index (mFI-5), and nutritional status, via the Nutritional Risk Index (NRI), affects short-term outcomes in patients undergoing minimally invasive RN. A retrospective analysis was conducted using the ACS-NSQIP database (2019-2022), identifying 7324 patients who underwent minimally invasive RN. Frailty was defined by an mFI-5 score ≥ 2, and malnutrition was identified with an NRI ≤ 97.5. Outcome measures included hospital length of stay, operative time, major complications, and mortality. Statistical analysis involved logistic regression to assess associations, with odds ratios (OR) and 95% confidence intervals (CI). Of 7324 patients, 24.5% were frail and 6.5% malnourished. Frail patients had significantly longer hospital stays (3.34 vs. 2.57 days, p < 0.001), extended operative times (178 vs. 165 min, p < 0.001), and higher rates of major complications (16.4% vs. 10.3%, p < 0.001) compared to non-frail patients. Malnourished patients also experienced higher major complication rates (30.7% vs. 11.6%, p < 0.001) and 30-day mortality (2.47% vs. 0.60%, p = 0.003). Preoperative albumin levels were the most predictive for mortality (AUC 0.72) and transfusion needs (AUC 0.72). Frailty and malnutrition significantly increase perioperative risks in patients undergoing minimally invasive RN. Preoperative assessments focusing on frailty and nutritional status may improve patient counseling, risk stratification, and help target preoperative interventions that may lead to improved perioperative outcomes.

Indexed as

FrailtyMalnutritionMinimally Invasive Surgical ProceduresNephrectomyNutritional StatusRobotic Surgical ProceduresAgedFemaleHumansLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsRetrospective StudiesRisk FactorsFrailtyNutritional statusPerioperative outcomesRadical nephrectomy

Identifiers

PMID40214944

What OpenQuestion holds

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Registered trials

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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.