Frailty is an independent predictor of 90-day complications following robot-assisted radical prostatectomy

Objective: The aim of this study is to analyze the association between the 11-item Modified Frailty Index (mFI) and 90-day post-operative complications in prostate cancer patients undergoing Robot-assisted Radical Prostatectomy (RARP). Methods: mFI was measured for 216 men who underwent RARP at a single institution. Mean ranks and proportions were compared with the Kruskal-Wallis test, Chi-square test of independence, and Fisher's exact test. Multivariate logistic regression was performed to determine predictors of 90-day post-operative complications after RARP. Results: Patients with higher pre-operative mFI (≥2) were more likely to be older in age (P= 0.047), have worse ECOG performance status (P=0.018), and worse ASA scores (P<0.01).  Intra-operative variables and pathological characteristics were similar between mFI groups. Multivariate logistic regression showed that mFI  ≥2 was a predictor of overall 90-day complications after surgery (OR=3.32, CI=1.16-9.54, P=0.026). Multivariate logistic regression also showed that mFI  ≥2 was a predictor of high-grade 90-day complications after surgery (OR=2.69, CI=1.24-5.85, P=0.012). Conclusion: Prostate cancer patients with higher pre-operative mFI scores were more likely to have a 90-day complication after RARP. mFI should be assessed pre-operatively for prostate cancer patients to determine the risk of post-operative morbidity and the best treatment plan.