This was a retrospective cohort study of the 2016-2017 National Inpatient Sample from the Healthcare Cost and Utilization Project analyzing relationships between frailty, as determined by the Hospital Frailty Risk Score (HFRS), a predictive tool based on ICD-10 codes, Charlson Comorbidity Index (CCI) and postoperative complications in women undergoing apical POP repair. 9,028 women were identified, with a 12.7% frailty rate and 12.2% complication rate. Multiple regression models indicated women of the White race, urban hospital location, large hospital bed size, older age, and Medicaid payers were more likely to be frail. Frailty was most predictive of postoperative complications (OR 5.77, 95% CI 4.97-6.70) while age was a negative predictor (0.98, 0.98-0.99). Black race (Black 1.26, 0.98-1.61), rural hospital location (1.31, 1.01-1.69), Medicaid payer status (1.57, 1.30-1.90), and high CCI (4.45, 3.49-5.67) were also associated with increased risk of postoperative complications. The authors concluded that apical POP procedure patients who are frail were more likely to be White, older, pay with Medicare, undergo surgery at a large, urban hospital, and experienced complications. Race and hospital size did not have a significant ability to predict complications. Paradoxically, patients at rural hospitals were more likely to experience complications despite being less frail overall. Medicare payers were at higher risk as well.
Presented by: Sirpi Nackeeran, Alejandra Guevara Mendez, Camilo Acosta, Laura Martin, Raveen Syan, Katherine Amin, University of Miami, Miller School of Medicine, University of Miami, Department of Urology, University of Miami, Department of Medicine
Written by: Diane K. Newman, DNP, ANP-BC, FAAN, an Adjunct Professor of Urology in Surgery, Perelman School of Medicine, University of Pennsylvania and Co-Director of the Penn Center for Continence and Pelvic Health