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Objectives—To evaluate the association of frailty, a measure of diminished physiologic reserve, with both major and minor surgical complications among patients undergoing urologic surgery. Materials and Methods—Using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2007 to 2013, we identified all urologic cases that appeared more than 1000 times in the dataset among patients age 40 and older. Frailty was measured using the NSQIP Frailly Index (FI), a validated measure that includes 11 impairments such as decreased functional status and impaired sensorium. We created multivariable logistic regression models using the NSQIP Frailty Index to assess major and minor complications after surgery. Results—We identified 95,108 urologic cases representing 21 urologic procedures. The average frequency of complications per individual was 11.7%, with the most common complications being hospital readmission (6.2%), blood transfusion (4.6%), and urinary tract infection (3.1%). Major and minor complications increased with increasing NSQIP-FI. Frailly remained strongly associated with complications after adjustment for year, age, race, smoking status, and method of anesthesia [adjusted OR 1.74 (95% CI 1.64, 1.85) NSQIP-FI 0.18+]. Increasing NSQIP-FI was associated with increasing frequency of complications within age groups (by decade) up to age 81 and across most procedures. Corresponding Author: Anne M. Suskind, MD, MS, 400 Parnassus Avenue, Box 0738, San Francisco, CA 94143-0738, (415)476-1611, Anne.Suskind@ucsf.edu. The American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in the ACS NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors. Conflicts of Interest: None disclosed HHS Public Access Author manuscript BJU Int. Author manuscript; available in PMC 2016 May 01. Published in final edited form as: BJU Int. 2016 May ; 117(5): 836–842. doi:10.1111/bju.13399. A uhor M anscript

the journal of urology/the journal of urology

PD02-01 THE IMPACT OF FRAILTY ON COMPLICATIONS IN PATIENTS UNDERGOING COMMON UROLOGIC PROCEDURES; A STUDY FROM THE AMERICAN COLLEGE OF SURGEONS NATIONAL SURGICAL QUALITY IMPROVEMENT DATABASE