Comprehensive geriatric assessment of risk factors associated with adverse outcomes and resource utilization in cancer patients undergoing abdominal surgery. Issue 3 (26th June 2013)

• Record Type: Journal Article
• Authors: Badgwell, Brian; Stanley, Jordan; Chang, George J.; Katz, Matthew H.G.; Lin, Heather Y.; Ning, Jing; Klimberg, Suzanne V.; Cormier, Janice N.
• Is Part Of: Journal of surgical oncology. Volume 108:Issue 3(2013:Sep. 01)
• Page Start: 182
• Page End: 186
• Publication Date: 2013-06-26
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23369
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="jso23369-sec-0001" sec-type="section"> <title>Background</title> <p>The purpose of this prospective study was to identify risk factors for adverse outcomes or increased resource utilization after abdominal cancer surgery in geriatric patients.</p> </sec> <sec id="jso23369-sec-0002" sec-type="section"> <title>Methods</title> <p>Baseline clinical and geriatric assessment variables including functional status, nutritional status, comorbidity index, mental status, depression scale score, fatigue inventory scale, and polypharmacy scale were prospectively recorded for patients age ≥65 undergoing intra‐abdominal oncologic surgery. Outcome variables included morbidity, mortality, discharge to nursing facility, prolonged hospital stay, and readmission.</p> </sec> <sec id="jso23369-sec-0003" sec-type="section"> <title>Results</title> <p>Of 111 patients, surgery type was colorectal in 40%, hepatopancreatobiliary in 30%, and gastric/duodenal in 14%. Variables associated with discharge to a nursing facility on multivariate analysis included weight loss ≥10% (OR 6.52 [95% CI: 1.43–29.76], <italic>P</italic> = 0.02), ASA score ≥2 (OR 5.08 [1.13–22.77], <italic>P</italic> = 0.03), and ECOG score ≥2 (OR 4.51 [1.03–19.71], <italic>P</italic> = 0.04). Variables independently associated with prolonged hospital stay included weight loss ≥10% (OR 4.03 [1.13–14.43], <italic>P</italic> = 0.03), the presence of polypharmacy (OR 2.45 [1.09–5.48], <italic>P</italic> = 0.03), and distant disease (OR 0.37 [0.15–0.91], <italic>P</italic> = 0.03). No variables were associated with morbidity or readmission.</p> </sec> <sec id="jso23369-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Pre‐operative clinical and geriatric assessment tools can help predict the need for discharge to a nursing facility or increased length of stay. Future studies will be required to identify patients suitable for interventions to decrease hospital and post‐discharge resource utilization. <italic>J. Surg. Oncol. 2013; 108:182–186</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>