Comprehensive geriatric assessment can predict complications in elderly patients after elective surgery for colorectal cancer: A prospective observational cohort study

Kristjansson, Siri Rostoft; Nesbakken, Arild; Jordhøy, Marit S.; Skovlund, Eva; Audisio, Riccardo A.; Johannessen, Hans-Olaf; Bakka, Arne; Wyller, Torgeir Bruun

doi:10.1016/j.critrevonc.2009.11.002

Cited by 408 publications

(342 citation statements)

References 68 publications

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“…A systematic review published in 2014 showed that frailty was associated with a nearly 5-fold increase in the risk of serious cardiac and cerebrovascular events (odds ratio 4.89), and this association was stronger in older patients undergoing transcatheter aortic valve replacement (TAVR) (odds ratio 3.31 to 4.89) compared to younger patients scheduled for bypass grafting or valve surgery (odds ratio 1.10 to 3.16) [8]. Of note, however, our findings are in agreement with data indicating discordance between chronological age and individual physiologic reserves [1,4]. This indicates that although age is a risk factor for mortality and postoperative complications, it is not a direct determinant of outcomes among the elderly but rather a correlate of comorbidities [14].…”

Section: Discussionsupporting

confidence: 58%

“…These persons are at a much increased risk of trauma (mostly due to falls), disability, and dependence, with a need for long-term care at home or in nursing care facilities [2]. Frailty often coexists with comorbidities (often expressed as the number of concomitant conditions) but these are not synonymous terms [4]. Quality of life of frail subjects is not satisfactory [2].…”

Section: Introductionmentioning

confidence: 99%

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Kruchość chorych kierowanych na operacje kardiochirurgiczne — badanie pilotażowe

et al. 2017

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Agnieszka Wiórek jest studentką VI roku Wydziału Lekarskiego z Oddziałem Lekarsko-Dentystycznym w Zabrzu Śląskiego Uniwersytetu Medycznego w Katowicach. Obecnie pełni funkcję Przewodniczącej Studenckiego Koła Naukowego działającego pod kierownictwem dr. hab. n. med. Łukasza Krzycha przy Katedrze Anestezjologii i Intensywnej Terapii Uniwersyteckiego Centrum Klinicznego Śląskiego Uniwersytetu Medycznego w Katowicach. W przyszłości planuje rozpoczęcie szkolenia specjalizacyjnego z anestezjologii i intensywnej terapii oraz kontynuowanie rozwoju swojej działalności naukowej. W wolnym czasie trenuje jeździectwo. AbstractIntroduction. Frailty has been recently approved in many surgical fields as the acknowledged preoperative predictor of adverse postoperative complications. Several methods are available to assess frailty assessment which focus on different patient-related data. The aims of the study were: 1) to verify whether frailty may predict early postoperative complications in cardiac surgery; and 2) to investigate the agreement between objective and subjective assessment of frailty.

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Kruchość chorych kierowanych na operacje kardiochirurgiczne — badanie pilotażowe

et al. 2017

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“…Most studies were observational (23 of 35) with a total of 1 153 684 patients available for the analysis. Cohorts were composed of patients undergoing lower gastrointestinal (GI) surgery (10 studies), upper GI surgery (6), mixed GI surgery (4), gynaecological surgery (6), urological surgery (4) and mixed abdominal surgery (6) ( Table 1)1 12, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54.…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta-analysis of frailty as a predictor of morbidity and mortality after major abdominal surgery

et al. 2017

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BackgroundFrailty is associated with poor prognosis, but the multitude of definitions and scales of assessment makes the impact on outcomes difficult to assess. The aim of this study was to quantify the effect of frailty on postoperative morbidity and mortality, and long‐term mortality after major abdominal surgery, and to evaluate the performance of different frailty metrics.MethodsAn extended literature search was performed to retrieve all original articles investigating whether frailty could affect outcomes after elective major abdominal surgery in adult populations. All possible definitions of frailty were considered. A random‐effects meta‐analysis was carried out for all outcomes of interest. For postoperative morbidity and mortality, overall effect sizes were estimated as odds ratios (OR), whereas the hazard ratio (HR) was calculated for long‐term mortality. The potential effect of the number of domains of the frailty indices was explored through meta‐regression at moderator analysis.ResultsA total of 35 studies with 1 153 684 patients were analysed. Frailty was associated with a significantly increased risk of postoperative major morbidity (OR 2·56, 95 per cent c.i. 2·08 to 3·16), short‐term mortality (OR 5·77, 4·41 to 7·55) and long‐term mortality (HR 2·71, 1·63 to 4·49). All domains were significantly associated with the occurrence of postoperative major morbidity, with ORs ranging from 1·09 (1·00 to 1·18) for co‐morbidity to 2·52 (1·32 to 4·80) for sarcopenia. No moderator effect was observed according to the number of frailty components.ConclusionRegardless of the definition and combination of domains, frailty was significantly associated with an increased risk of postoperative morbidity and mortality after major abdominal surgery.

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“…To quantify frailty, these studies sum the number of frailty characteristics (some of which are geriatric syndromes) present in an older adult prior to an operation. In these studies, the geriatric syndromes of impaired cognition, [7][8][14][15][16] , poor mobility, [7][8][16][17][18] incontinence, 14 functional decline 7-8, 14-15 and having fallen [7][8] are abnormal characteristics used in sum to define frailty which has been closely related to adverse postoperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

Who would have thought? Asking an older adult if they have fallen predicts surgical outcomes

Jones

Robinson

2012

Journal of the American College of Surgeons

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Comprehensive geriatric assessment can predict complications in elderly patients after elective surgery for colorectal cancer: A prospective observational cohort study

Abstract: CGA can identify frail patients who have a significantly increased risk of severe complications after elective surgery for colorectal cancer.

Cited by 408 publications

References 68 publications

Kruchość chorych kierowanych na operacje kardiochirurgiczne — badanie pilotażowe

Kruchość chorych kierowanych na operacje kardiochirurgiczne — badanie pilotażowe

Systematic review and meta-analysis of frailty as a predictor of morbidity and mortality after major abdominal surgery

Who would have thought? Asking an older adult if they have fallen predicts surgical outcomes

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