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J Geriatr Oncol. 2017 Sep;8(5):320-327. doi: 10.1016/j.jgo.2017.07.008. Epub 2017 Aug 3.

Value of geriatric screening and assessment in predicting postoperative complications in patients older than 70 years undergoing surgery for colorectal cancer.

Author information

1
Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium. Electronic address: katleen.fagard@gmail.com.
2
Faculty of Medicine, KU Leuven, Leuven, Belgium.
3
Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium.
4
Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.
5
Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
6
Beernem, Belgium.
7
Department of Oncology, KU Leuven, Leuven, Belgium; Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.
8
Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.

Abstract

OBJECTIVES:

This study examines the association between geriatric screening and geriatric assessment (GA) and the risk of 30-day postoperative complications (30d-POCs) in older patients undergoing surgery for colorectal cancer (CRC).

MATERIALS AND METHODS:

Patients were identified from a prospectively collected database (2009-2015). All patients underwent geriatric screening with the G8 screening tool and the Flemish version of the Triage Risk Screening Tool (fTRST). The patients with an abnormal G8 score (G8≤14) received a GA, including living situation, basic and instrumental activities of daily living (ADL and I-ADL), falls, fatigue, cognition, depression, nutrition, comorbidities, and polypharmacy. 30d-POCs were retrospectively collected from the medical records and classified into Clavien-Dindo severity grades. The primary endpoint was the occurrence of Clavien-Dindo grade 2 and above (CD≥2) 30d-POCs. To identify predictive variables, logistic regression analyses were used.

RESULTS:

190 patients, aged ≥70years, were included. Seventy-eight (41.1%) had CD≥2 30d-POCs, and the 30-day mortality was 1.6%. In univariable logistic regressions, the following variables were associated with CD≥2 30d-POCs (PWald<0.05): age, G8, ECOG-performance status (ECOG-PS), tumor location, and surgical approach. Age and surgical approach independently predicted 30d-POCs. In the G8≤14 patients (receiving a complete GA, n=115), ADL was the only GA variable associated with CD≥2 30d-POCs.

CONCLUSION:

In this study examining the predictive value of geriatric screening and GA in predicting CD≥2 30d-POCs, the G8 screening tool was associated in univariable analysis, but did not remain in multivariable analysis. In the G8≤14 group receiving GA, ADL was the only predictive GA variable.

KEYWORDS:

Colorectal cancer; Elderly; Geriatric assessment; Geriatric screening; Postoperative complications

PMID:
28781062
DOI:
10.1016/j.jgo.2017.07.008
[Indexed for MEDLINE]

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