Preoperative 5-Factor Frailty Index and Clavien-Dindo Grade ≥ II Complications Following Open Radical Nephrectomy: A...

Area of Science:

• Urology
• Surgical Oncology
• Geriatrics

Background:

• Preoperative frailty assessment is underutilized in open radical nephrectomy for renal cell carcinoma (RCC).
• Prospective data on the 5-Factor Frailty Index (5-IFi) in this context are limited.

Purpose of the Study:

• To investigate the association between preoperative 5-Factor Frailty Index (5-IFi) scores and postoperative complications.
• To evaluate the 5-IFi's predictive value for complications, length of stay, and readmission after radical nephrectomy.

Main Methods:

• Prospective cohort study of 30 adults undergoing open radical nephrectomy for RCC.
• Preoperative 5-IFi scoring using medical records and medication lists.
• Primary outcome: Clavien-Dindo grade ≥ II complications; secondary outcomes: length of stay, 30-day readmission.

Main Results:

• 14 patients (46.7%) experienced grade ≥ II complications; 9 patients (30.0%) were frail (5-IFi ≥ 2).
• Higher 5-IFi scores were significantly associated with increased odds of complications (OR 2.10, 95% CI 1.00-5.91).
• Frail patients had higher complication rates (77.8% vs. 33.3%) and longer hospital stays (p=0.035).

Conclusions:

• A higher preoperative 5-Factor Frailty Index (5-IFi) score is associated with postoperative complications in RCC patients undergoing radical nephrectomy.
• Findings are preliminary due to small sample size and exclusively grade II events.
• Multicenter validation is necessary to guide clinical application of the 5-IFi for risk stratification.