ORCID (Optional)


Document Type

Original Report


Higher Education | Medicine and Health Sciences | Urology


Background: Kidney stones are prevalent, and surgical treatment is based on multiple factors. Frailty is the collective decline of organ systems that can lead to adverse events and is considered prior to surgery for risk-benefit analysis. The National Surgical Quality Improvement Program (NSQIP) utilizes risk-adjusted data to monitor outcomes, provide quality benchmarks, and decrease complications. The impact of frailty with the modified 5-item frailty index has not previously been evaluated for patients undergoing urolithiasis procedures.

Methods: Data was collected from 1329 patients who underwent surgery for urolithiasis. The primary outcome was 30-day all-cause morbidity. Associations between variables, including those within the 5-item modified frailty index (history (hx) of diabetes, CHF, COPD, antihypertensive usage, functional status), and all-cause morbidity were assessed. Additional analysis looked at two specific outcomes: readmissions and return to OR.

Results: A total of 1329 patients were assessed. Of the variables in the frailty index, COPD and HTN requiring medications were not associated with higher morbidity. Dependent functional status (OR = 2.47, p = 0.006), hx of CHF (OR = 4.69, p = 0.02), and insulin-dependent diabetes (OR = 1.89, p = 0.02) were associated with higher morbidity. Type of procedure was highly linked with morbidity, with percutaneous procedure (OR = 4.72, p < 0.001) and open procedures (OR = 2.43, p < 0.001) being associated with patient morbidity. Age was the only variable associated with increased return to OR and readmission rates.

Conclusion: Urologists should consider patient age and comorbidities when selecting the surgical route for urolithiasis.




urolithiasis, frailty, morbidity, complications, readmission

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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