Frailty is a predictor of moderate to severe pain after robot-assisted laparoscopic prostatectomy: A case-control study (FRAP study).

To investigate the association of pain with frailty in patients with localized prostate cancer (PC) who underwent robot-assisted laparoscopic radical prostatectomy (RARP).

Between January 2017 and June 2019, we prospectively evaluated the geriatric 8 (G8) score, simplified frailty index (sFI), and numerical rating scale (NRS) of 154 patients with localized PC who underwent RARP at our institution. NRS was measured on preoperative day 0, postoperative days 1, 2, 3, and at discharge. Moderate to severe pain was defined as NRS ≥ 5, whereas frailty was defined as G8 ≤ 14. The primary objectives of this study were to investigate the effects of moderate to severe pain (NRS ≥ 5) on frailty, postoperative complications, and the use of analgesics after RARP. Our secondary objectives were the effect of frailty on postoperative complications and the use of analgesics.

The median age of participants was 69 years. Of 154 patients, 37 (24%) and 61 (40%) were classified to have NRS ≥ 5 and G8 ≤ 14, respectively. Patients with NRS > 5 presented significantly association with G8 < 14, whereas they did not show the association with sFI, complication, or analgesics. Multivariate logistic regression analysis showed that G8 ≤ 14 was significantly associated with NRS ≥ 5. Frailty was not significantly associated with postoperative complications and analgesics.

Frailty was significantly associated with moderate to severe pain after RARP, and might be a potential predictor of postoperative pain. Frail patients require individual care to avoid painful experiences.

BJUI compass. 2020 May 14*** epublish ***

Masaki Momota, Shingo Hatakeyama, Osamu Soma, Itsuto Hamano, Naoki Fujita, Teppei Okamoto, Kyo Togashi, Tomoko Hamaya, Tohru Yoneyama, Hayato Yamamoto, Takahiro Yoneyama, Yasuhiro Hashimoto, Chikara Ohyama

Department of Urology Hirosaki University Graduate School of Medicine Hirosaki Japan., Department of Advanced Blood Purification Therapy Hirosaki University Graduate School of Medicine Hirosaki Japan., Department of Advanced Transplant and Regenerative Medicine Hirosaki University Graduate School of Medicine Hirosaki Japan.

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