ArticleBJUI compass2026
Comparative performance of mFI-5 and mFI-11 thresholds in predicting outcomes after holmium laser enucleation of the prostate.
Article in BJUI compass, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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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Who cites it
1 citing paper in PubMed.
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Authors and funding
9 authors.
Funding
Abstract
Objectives: This work aimed to evaluate the safety and efficacy of holmium laser enucleation of the prostate across different degrees of frailty using the 11-item and 5-item modified frailty indices and to compare perioperative and postoperative outcomes across multiple frailty thresholds. Materials and Methods: We retrospectively reviewed patients who underwent HoLEP at our institution between July 2017 and August 2025. Frailty was assessed using mFI-11 (cutoffs ≥0.18, ≥0.27, ≥0.36) and mFI-5 (≥0.40). Perioperative variables, functional outcomes, and postoperative complications were compared. Agreement between frailty definitions was assessed using Cohen's kappa. Logistic regression was used to evaluate complication risk. Results: Among 857 patients, overall frailty burden was low ranging from 16.2% with mFI-11 ≥0.36 to 52.6% with mFI-11 ≥0.18, and 27.5% by mFI-5 ≥0.40. Functional outcomes improved in all groups, though patients defined as frail by mFI-11 ≥0.36 demonstrated less improvement in IPSS at 1 year and lower Qmax at select time points. Major complications were uncommon and did not demonstrate a consistent frailty gradient. Transfusion risk was higher only at mFI-11 ≥0.36. Urinary tract infection showed a dose-response relationship with increasing mFI-11, with approximately a 20% increase in odds per one-point increase. Conclusions: HoLEP is safe and effective across frailty definitions. Frailty cutoff selection meaningfully influences risk stratification, with mFI-11 ≥0.36 providing the most clinically informative discrimination.
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