Electronic fitness assessment spots adverse outcomes tied to radical cystectomy

A recent study has shown the feasibility of a novel electronic tool to assess fitness in older patients undergoing radical cystectomy. Physical limitations and overall impairment are associated with higher intensive care unit (ICU) admission rates and adverse postoperative outcomes.

“Frailty is associated with adverse outcomes following radical cystectomy,” the authors said.

In this study, 80 patients aged >75 years completed the electronic rapid fitness assessment before undergoing radical cystectomy between February 2015 and February 2018. They were perioperatively comanaged by the Geriatrics Service.

The authors evaluated physical and cognitive functions over 12 domains and compiled an accumulated geriatric deficit score. They also assessed hospital length of stay, discharge disposition, unplanned ICU admissions, urgent care visits, readmissions, complications, and deaths.

Sixty-five patients (median age, 80 years; 80 percent male) who underwent radical cystectomy for bladder cancer without concomitant procedures completed the assessment.

Impairments identified within electronic rapid fitness assessment domains, including Timed Up and Go, occurred in a higher number of patients with ICU admission, urgent care visit, and major complications. Readmission rates were comparable between patients with or without deficits identified.

In addition, a higher accumulated geriatric deficit score significantly correlated with ICU admission (p=0.035), death within 90 days (p=0.037), and discharge to other than home (p=0.0002).

“Larger studies in less resourced environments are required to validate these findings,” the authors said.