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Modified Frailty Index predicts postoperative complications following adult-acquired buried penis surgery: A
Steven P Moura1, Ellen C Shaffrey1, Chloe S Lam1
1Division of Plastic and Reconstructive Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Background:
Given that patients with morbid obesity are predisposed to frailty, we sought to determine whether the 5-Factor Modified Frailty Index (mFI-5) predicts postoperative complications following surgery for adult-acquired buried penis, and secondarily, to compare the mFI-5 to body mass index (BMI) and American Society of Anesthesiologists (ASA) status as preoperative risk stratification measures.
Methods:
We included all patients who underwent surgical management for adult-acquired buried penis at an academic Level I trauma center between 2015 and 2023. A manual chart review was performed to collect data on patient demographics, modified frailty index variables, intraoperative data, postoperative outcomes, and complications.
Results:
A total of 55 patients underwent surgical repair of adult-acquired buried penis, with 26 experiencing postoperative complications (47.3%). Univariable regression analyses revealed that the mFI-5 was a significant predictor of postoperative complications (odds ratio [OR] 3.40, 95% confidence interval [CI]: 1.56-7.42, p = .002), ongoing postoperative urinary problems (OR 2.03, 95% CI: 1.02-4.05, p = .045), patient dissatisfaction with outcomes (OR 3.29, 95% CI: 1.35-8.02, p = .009), and persistent postoperative symptoms (OR 2.42, 95% CI: 1.10-5.35, p = .029). There was no significant association between ASA classification and postoperative complications (OR 1.59, 95% CI:.544-4.63, p = .398). Multivariable analysis demonstrated that the mFI-5 was an independent predictor of postoperative complications (OR 5.34, 95% CI: 1.80-15.9, p = .003) when controlling for BMI and age.
Conclusion:
The mFI-5 is an independent predictor of postoperative complications in patients undergoing surgical repair of adult-acquired buried penis. The simplicity of the index permits efficient preoperative risk stratification of adult-acquired buried penis patients and provides important counseling information that may not be reflected by age or BMI alone.
Insights
The 5-Factor Modified Frailty Index (mFI-5) predicts complications after adult-acquired buried penis surgery. This index offers better risk assessment than BMI or ASA status alone for these patients.
Area of Science:
- Urology
- Geriatrics
- Surgical Outcomes
Background:
- Morbid obesity is linked to frailty, increasing surgical risks.
- Adult-acquired buried penis surgery carries a significant risk of postoperative complications.
- Preoperative risk stratification is crucial for managing surgical outcomes.
Purpose of the Study:
- To evaluate the 5-Factor Modified Frailty Index (mFI-5) as a predictor of postoperative complications after adult-acquired buried penis surgery.
- To compare the predictive value of mFI-5 against Body Mass Index (BMI) and American Society of Anesthesiologists (ASA) status for risk stratification.
Main Methods:
- Retrospective chart review of 55 patients undergoing surgical repair for adult-acquired buried penis (2015-2023).
- Data collection included demographics, mFI-5 variables, intraoperative details, and postoperative outcomes.
- Statistical analysis involved univariable and multivariable regression to assess predictor variables.
Main Results:
- Nearly half (47.3%) of patients experienced postoperative complications.
- mFI-5 significantly predicted complications (OR 3.40), urinary issues (OR 2.03), dissatisfaction (OR 3.29), and persistent symptoms (OR 2.42).
- Multivariable analysis confirmed mFI-5 as an independent predictor (OR 5.34) when controlling for BMI and age; ASA status was not significant.
Conclusions:
- The mFI-5 is a valuable, independent predictor of postoperative complications in adult-acquired buried penis surgery.
- Its simplicity allows for efficient preoperative risk assessment and patient counseling.
- mFI-5 provides risk insights beyond age or BMI alone for surgical planning.
