Preoperative 5-Factor Frailty Index as a Predictor of Major Complications Following Open Radical Nephrectomy: A Prospective Cohort Study

作者：Abdal Ahmad · 发表于：Figshare · 年份：2026 · DOI：10.6084/m9.figshare.32148319 · 研究领域：Medicine、Surgery、Internal medicine

Background: Preoperative risk stratification for radical nephrectomy in renal cell carcinoma (RCC) remains imprecise when relying on chronological age or the American Society of Anesthesiologists physical status classification. The 5-Factor Frailty Index (5-IFi) has shown predictive value in retrospective database analyses; however, prospective validation in an exclusively open radical nephrectomy cohort is lacking. We evaluated the association between the preoperative 5-IFi score and major short-term morbidity following open radical nephrectomy. Methods : This prospective observational cohort study enrolled 30 adults with RCC who were scheduled for elective open radical nephrectomy at a tertiary center. The 5-IFi was calculated preoperatively from five clinical variables: pharmacologically managed hypertension, diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure, and dependence on Activities of Daily Living. The primary outcome was a Clavien-Dindo Grade ≥ 2 complication during index hospitalization. Exploratory penalized logistic regression, receiver operating characteristic analysis, and bootstrap resampling (3,000 iterations) were performed. Results: The primary outcome occurred in 14 (46.7%) patients. Patients with complications had a significantly higher median 5-IFi score (1.5 vs. 1.0; p = 0.030). A score ≥ 2 was associated with seven-fold higher odds of major complications (OR 7.00; 95% CI: 1.14–42.97; p = 0.046). Each 1-point increase ...