Purpose: Bladder outlet obstruction (BOO) is common in older adults. Many older adults who pursue surgery have additional vulnerabilities affecting surgical risk, including frailty. A clinical tool that builds on frailty to predict surgical outcomes for the spectrum of BOO procedures would be helpful to aid in surgical decision-making but does not currently exist.
Materials And Methods: Medicare beneficiaries undergoing BOO surgery from 2014 to 2016 were identified and analyzed using the Medicare MedPAR, Outpatient, and Carrier files. Eight different BOO surgery categories were created. Baseline frailty was calculated for each beneficiary using the Claims-Based Frailty Index (CFI). All 93 variables in the CFI and the 17 variables in the Charlson Comorbidity Index were individually entered into stepwise logistic regression models to determine variables most highly predictive of complications. Similar and duplicative variables were combined into categories. Calibration curves and tests of model fit, including C statistics, Brier scores, and Spiegelhalter values, were calculated to ensure the prognostic accuracy for postoperative complications.
Results: In total, 212,543 beneficiaries were identified. Approximately 42.5% were prefrail (0.15 ≤ CFI < 0.25), 8.7% were mildly frail (0.25 ≤ CFI < 0.35), and 1.2% were moderately-to-severely frail (CFI ≥0.35). Using stepwise logistic regression, 13 distinct prognostic variable categories were identified as the most reliable predictors of postoperative outcomes. Most models demonstrated excellent model discrimination and calibration with high C statistic and Spiegelhalter values, respectively, and high accuracy with low Brier scores. Calibration curves for each outcome demonstrated excellent model fit.
Conclusions: This novel risk assessment tool may help guide surgical prognostication among this vulnerable population.
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http://dx.doi.org/10.1097/JU.0000000000003978 | DOI Listing |
Int J Pediatr Otorhinolaryngol
January 2025
Department of Audiology, Faculty of Health Science, Istanbul Aydin University, Istanbul, Turkey. Electronic address:
Objective: The primary aim of this study was to examine the relationship between parental attitudes and language development in preschool children with cochlear implants. In addition, the study aimed to examine parental attitudes in relation to socio-demographic and cochlear implant related variables.
Methods: This study is based on the relational survey model.
Arch Gerontol Geriatr
January 2025
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore 117549, Singapore. Electronic address:
Background: Both air pollution and low socioeconomic status (SES) are associated with worse cognitive function. The extent to which low SES may compound the adverse effect of air pollution on cognitive function remains unclear.
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JMIR Form Res
January 2025
Division of Psychology, School of Health, Care and Social Welfare, Mälardalen University, Västerås/Eskilstuna, Sweden.
Background: Having a great amount of sedentary time is common among older adults and increases with age. There is a strong need for tools to reduce sedentary time and promote adherence to reduced sedentary time, for which eHealth interventions have the potential to be useful. Interventions for reducing sedentary time in older adults have been found to be more effective when elements of self-management are included.
View Article and Find Full Text PDFJ Med Internet Res
January 2025
AIMS Lab, Center for Neurosciences, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Background: Cognitive deterioration is common in multiple sclerosis (MS) and requires regular follow-up. Currently, cognitive status is measured in clinical practice using paper-and-pencil tests, which are both time-consuming and costly. Remote monitoring of cognitive status could offer a solution because previous studies on telemedicine tools have proved its feasibility and acceptance among people with MS.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!