Screening for predictors of adverse outcome in onco-geriatric surgical patients: A multicenter prospective cohort study. Issue 7 (July 2015)

• Record Type: Journal Article
• Authors: Huisman, M.G.; Audisio, R.A.; Ugolini, G.; Montroni, I.; Vigano, A.; Spiliotis, J.; Stabilini, C.; de Liguori Carino, N.; Farinella, E.; Stanojevic, G.; Veering, B.T.; Reed, M.W.; Somasundar, P.S.; de Bock, G.H.; van Leeuwen, B.L.
• Is Part Of: European journal of surgical oncology. Volume 41:Issue 7(2015:Jul.)
• Page Start: 844
• Page End: 851
• Publication Date: 2015-07
• Subjects: Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2015.02.018
• Languages: English
• ISSNs: 0748-7983

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Aims</title> <p id="abspara0010">The aim of this study was to investigate the predictive ability of screening tools regarding the occurrence of major postoperative complications in onco-geriatric surgical patients and to propose a scoring system.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">328 patients ≥70 years undergoing surgery for solid tumors were prospectively recruited. Preoperatively, twelve screening tools were administered. Primary endpoint was the incidence of major complications within 30 days. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using logistic regression. A scoring system was derived from multivariate logistic regression analysis. The area under the receiver operating characteristic curve (AUC) was applied to evaluate model performance.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">At a median age of 76 years, 61 patients (18.6%) experienced major complications. In multivariate analysis, Timed Up and Go (TUG), ASA-classification and Nutritional Risk Screening (NRS) were predictors of major complications (TUG<sub>>20</sub> OR 3.1, 95% CI 1.1–8.6; ASA<sub>≥3</sub> OR 2.8, 95% CI 1.2–6.3; NRS<sub>impaired</sub> OR 3.3, 95% CI 1.6–6.8). The scoring system, including TUG, ASA, NRS, gender and type of surgery, showed good accuracy (AUC: 0.81, 95% CI 0.75–0.86). The negative predictive value with a cut-off point >8 was 93.8% and the positive predictive value was 40.3%.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">A substantial number of patients experience major postoperative complications. TUG, ASA and NRS are screening tools predictive of the occurrence of major postoperative complications and, together with gender and type of surgery, compose a good scoring system.</p> </sec> </abstract>