Background: Frailty is a recent multidimensional concept of a contemporary growing interest for understanding the complex health status of elderly population. We aimed to assess the impact of frailty scores on the outcome and complication rate of holmium laser enucleation of prostate (HoLEP). Methods: A 7-year data of HoLEP patients in a single tertiary referral center were reviewed. The preoperative, operative, early, and late postoperative outcome data were collected and compared according to the preoperative frailty scores. Frailty was assessed preoperatively using the Modified Hopkins frailty score. Results: The study included 837 patients categorized into two groups: group I included 533 nonfrail patients (frailty score = 0), whereas group II included 304 frail patients (frailty score ≥1). The median (interquartile range) age was 70 (11) and 75 (11) years for groups I and II, respectively (<0.001). The 30-day perioperative complication rate (p = 0.005), blood transfusion (p = 0.013), failed voiding trial (p = 0.0015), and 30-day postoperative readmission (p = 0.0363) rates were significantly higher in frail patients of group II. The two groups were statistically comparable regarding postoperative international prostate symptom score (p = 0.6886, 0.6308, 0.9781), incontinence rate (p = 0.475, 0.592, 0.1546), postvoid residual (p = 0.5801, 0.1819, 0.593) at 6 weeks and 3 months, and 1-year follow-up intervals, respectively. Conclusion: In elderly patients undergoing HoLEP, the preoperative frailty scores strongly correlate with the risk of perioperative complications. Frail patients should be counseled regarding their relative higher risk of early perioperative complications although they gain the same functional profit of HoLEP as nonfrail patients.

中文翻译：

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术前衰弱评分可预测钬激光前列腺剜除术的早期术后并发症。

背景：虚弱是一个新近出现的多维概念，当代人们对了解老年人复杂的健康状况越来越感兴趣。我们的目的是评估衰弱评分对钬激光前列腺剜除术 (HoLEP) 的结果和并发症发生率的影响。方法：回顾了单个三级转诊中心的 HoLEP 患者 7 年数据。根据术前衰弱评分收集并比较术前、术中、术后早期和晚期结果数据。术前使用改良霍普金斯衰弱评分评估衰弱程度。结果：该研究纳入了 837 名患者，分为两组：第一组包括 533 名非虚弱患者（虚弱评分 = 0），而第二组包括 304 名虚弱患者（虚弱评分≥1）。I 组和 II 组的中位年龄（四分位距）分别为 70 (11) 和 75 (11) 岁 (<0.001)。该组体弱患者的 30 天围手术期并发症发生率 (p = 0.005)、输血率 (p = 0.013)、排尿试验失败率 (p = 0.0015) 和术后 30 天再入院率 (p = 0.0363) 显着较高二. 两组在术后第 6 周和第 3 周的国际前列腺症状评分（p = 0.6886、0.6308、0.9781）、失禁率（p = 0.475、0.592、0.1546）、排尿后残留（p = 0.5801、0.1819、0.593）方面具有统计学可比性。分别为几个月和一年的随访间隔。结论：在接受 HoLEP 的老年患者中，术前虚弱评分与围手术期并发症的风险密切相关。尽管体弱患者获得与非体弱患者相同的 HoLEP 功能获益，但仍应告知体弱患者早期围手术期并发症的风险相对较高。