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J Geriatr Oncol. 2019 Feb 7. pii: S1879-4068(18)30234-0. doi: 10.1016/j.jgo.2019.01.020. [Epub ahead of print]

Preoperative geriatric assessment and follow-up of patients older than 75 years undergoing elective surgery for suspected colorectal cancer.

Author information

1
Department of Neurobiology, Care Sciences and Society, both at Karolinska Institute, Stockholm, Sweden; Subject Aging, Karolinska University Hospital Huddinge, Stockholm, Sweden. Electronic address: katja.schubert-samuelsson@sll.se.
2
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Centre for Digestive Diseases, Karolinska University Hospital Solna, Stockholm, Sweden.
3
Department of Neurobiology, Care Sciences and Society, both at Karolinska Institute, Stockholm, Sweden; Subject Aging, Karolinska University Hospital Huddinge, Stockholm, Sweden.
4
Department of Surgery and Perioperative Sciences, Umeå University, Sweden.

Abstract

OBJECTIVES:

We investigated the predictive value of specific tools used in a Comprehensive Geriatric Assessment (CGA) with regard to postoperative outcome in patients 75 years and older undergoing elective colorectal cancer (CRC) surgery. Furthermore, recovery was followed over the first postoperative year using the same assessment tools.

MATERIAL AND METHODS:

Baseline clinical and CGA variables including functional and nutritional status, pressure sore risk, fall risk, cognition, depression, polypharmacy, comorbidity, and health-related quality-of-life (HRQoL) were prospectively recorded. Outcome variables were postoperative complications and length of stay (LOS). Patients were likewise followed up at one, three and twelve months postoperatively.

RESULTS:

Forty-nine patients underwent surgery (median age 81 years). Forty-three per cent had ASA (American Society of Anesthesiologists) class 2 47% had ASA class 3. Postoperative complications occurred in 32.7%. Median LOS was eight days. In univariate analyses, none of the parameters tested predicted postoperative complication or LOS. During follow-up, all patients recovered to baseline values apart from HRQoL which was still reduced at three and twelve months (p = .017). Nutritional status had improved twelve months after surgery (p = .011).

CONCLUSIONS:

No association could be found in this study between the results of a comprehensive geriatric assessment and prolonged length of stay or postoperative complication rate after elective surgery for colorectal cancer. Patients recovered well during the first year after surgery. Quality of life, however, was still lower than prior to surgery.

KEYWORDS:

Colorectal cancer surgery; Comprehensive geriatric assessment; Length of stay; Older patients; Postoperative complication; Recovery

PMID:
30745117
DOI:
10.1016/j.jgo.2019.01.020

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