In 2015, I underwent 3 urological surgeries without complications. In preparation for each surgery, I increased my yoga training sessions focusing on my core and pelvic floor. This recent study provides evidence that being “in shape” before urological surgery can half your risk of complications.
The study’s objectives were to evaluate the association of frailty, a measure of diminished physiological reserve, with both major and minor surgical complications among patients undergoing urological surgery.
The researchers used data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) from 2007 to 2013. They identified all urological cases that appeared > 1000 times in the dataset among patients aged ≥40 years. Frailty was measured using the NSQIP frailty index (FI), a validated measure that includes 11 impairments, such as decreased functional status and impaired sensorium. They created multivariable logistic regression models using the frailty index to assess major and minor complications after surgery.
They identified 95,108 urological cases representing 21 urological 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%).
They discovered that major and minor complications increased with increasing frailty. Frailty remained strongly associated with complications irrespective of year, age, race, smoking status and method of anaesthesia. Increasing frailty was associated with increasing frequency of complications within age groups (by decade) up to age 81 years and across most procedures.
They concluded that frailty strongly correlates with risk of postoperative complications among patients undergoing urological surgery. This was true no matter what age groups and across most urological procedures.
Tests of frailty revealed that patients who were frail were almost twice more likely to experience complications after surgery.
“We found that frailty was a significant predictor of postoperative complications independent of age and across most procedures evaluated, making it a very important factor to consider in preoperative decision-making and counseling,” said Dr. Anne Suskind, lead author of the BJU International
A Canadian study found a similar result with prostate cancer surgery as well. Both complications and post-surgery length of stay were negatively affected by frailty.
What is the lesson from these studies? Be “in shape” before undergoing any surgery so that you will have less post-surgery complications.
Suskind, A. M., Walter, L. C., Jin, C., Boscardin, J., Sen, S., Cooperberg, M. R. and Finlayson, E. (2016), Impact of frailty on complications in patients undergoing common urological procedures: a study from the American College of Surgeons National Surgical Quality Improvement database. BJU International. doi: 10.1111/bju.13399