Use of a Comprehensive Geriatric Assessment to Predict Short-Term Postoperative Outcome in Elderly Patients With Colorectal Cancer.
- Author:
Yoon Hyun LEE
1
;
Heung Kwon OH
;
Duck Woo KIM
;
Myong Hoon IHN
;
Jee Hyun KIM
;
Il Tae SON
;
Sung Il KANG
;
Gwang Il KIM
;
Soyeon AHN
;
Sung Bum KANG
Author Information
- Publication Type:Original Article
- Keywords: Colorectal neoplasms; Comprehensive geriatric assessment; Complication
- MeSH: Activities of Daily Living; Aged*; Carcinoembryonic Antigen; Classification; Colorectal Neoplasms*; Comorbidity; Geriatric Assessment*; Humans; Korea; Postoperative Complications; Prospective Studies; Risk Factors; Tertiary Care Centers
- From:Annals of Coloproctology 2016;32(5):161-169
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: This study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer. METHODS: Elderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA. RESULTS: A total of 240 patients, with a mean age of 76.7 ± 5.2 years, were enrolled. Ninety-five patients (39.6%) were classified as "high-risk" and 99 patients (41.3%) as having postoperative complications. The univariate analysis indicated that risk factors for postoperative complications were age, American Society of Anesthesiologists physical status classification, serum hemoglobin, carcinoembryonic antigen, cancer stage, and "high-risk" status. The multivariable analyses indicated that "high-risk" status (odds ratio, 2.107; 95% confidence interval, 1.168–3.804; P = 0.013) and elevated preoperative carcinoembryonic antigen (odds ratio, 2.561; 95% confidence interval, 1.346–4.871, P = 0.004) were independently associated with postoperative complications. A multivariable analysis of the individual CGA domains indicated that high comorbidities and low activities of daily living were significantly related with postoperative complications. CONCLUSION: A preoperative CGA indicating "high-risk" was associated with major postoperative complications in elderly patients who underwent surgery for colorectal cancer. Thus, using the CGA to identify elderly colorectal-cancer patients who should be given more care during postoperative management may be clinically beneficial.
