The Comprehensive Complication Index is Related to Frailty in Elderly Surgical Patients

Artíles-Armas, Manuel; Roque‐Castellano, Cristina; Conde-Martel, Alicia; Marchena‐Gómez, Joaquín

doi:10.1016/j.jss.2019.06.011

Cited by 31 publications

(12 citation statements)

References 37 publications

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“…47 It has been previously shown that frailty can better predict mortality than chronological age, can provide information to help identify persons at risk for disability and poor prognosis, and has valid and reliable diagnostic accuracy and predictive ability for adverse health outcomes, including functional disability, hospitalization, post-treatment complications, and comorbidities. [48][49][50][51][52] Although few studies examine the relationship between chemosensory dysfunction and frailty, findings have been inconsistent. 9,53,54 One study of 141 older Japanese participants using objective smell and taste tests found a significant association of mOD with a frailty index, but not mGD.…”

Section: Discussionmentioning

confidence: 99%

“…Frailty is 1 such measure, characterized as a state of reduced physical reserve and increased vulnerability to illness and disability 47 . It has been previously shown that frailty can better predict mortality than chronological age, can provide information to help identify persons at risk for disability and poor prognosis, and has valid and reliable diagnostic accuracy and predictive ability for adverse health outcomes, including functional disability, hospitalization, post‐treatment complications, and comorbidities 48–52 …”

Section: Discussionmentioning

confidence: 99%

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The association of frailty with olfactory and gustatory dysfunction in older adults: a nationally representative sample

Bernstein

Roxbury

Lin

et al. 2020

Int Forum Allergy Rhinol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The association of frailty with olfactory and gustatory dysfunction in older adults: a nationally representative sample

Bernstein

Roxbury

Lin

et al. 2020

Int Forum Allergy Rhinol

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“…Frailty has been proposed as a good predictor of postoperative complications in the elderly patient undergoing a major gastrointestinal procedure [23], but this variable could not be collected due to the retrospective nature of our study. Comorbidity measured by the Charlson Comorbidity Index in the general population has been related to anastomotic leak, postoperative complications and death in Chinese patients [24], but there are not published data focused on this topic specifically in nonagenarians.…”

Section: Discussionmentioning

confidence: 99%

Colorectal cancer surgery in selected nonagenarians is relatively safe and it is associated with a good long-term survival: an observational study

et al. 2020

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Background: Advanced age is a risk factor for colorectal cancer, and very elderly patients often need to be surgically treated. This study aimed to analyze the outcomes of a cohort of nonagenarian patients operated on for colorectal cancer. Methods: Observational study conducted on a cohort of 40 nonagenarian patients, who were treated surgically for colorectal cancer between 2000 and 2018 in our institution. Clinical data, ASA score, Charlson Comorbidity Index, Surgical Mortality Probability Model, tumor characteristics, and nature and technical features of the surgical procedure, were recorded. The Comprehensive Complication Index (CCI) and survival time after the procedure were recorded as outcome variables. Univariate and multivariate analyses were performed in order to define risk factors for postoperative complications and long-term survival. Results: Out of the 40 patients, 13 (32.5%) were men, 27 (67.5%) women, and mean age 91.6 years (SD ± 1.5). In 24 patients (60%), surgery was elective, and in 16 patients (40%), surgery was emergent. Curative surgery with intestinal resection was performed in 34 patients (85%). In 22 patients (55%), intestinal continuity was restored by performing an anastomosis. The median CCI was 22.6 (IRQ 0.0-42.6). Operative mortality was 10% (4 patients). Cumulative survival at 1, 3, and 5 years was 70%, 47%, and 29%, respectively. In multivariate analysis, only the need for transfusion remained as an independent prognostic factor for complications (p = 0.021) and TNM tumor stage as a significant predictor of survival (HR 3.0, CI95% 1.3-7.2). Conclusions: Colorectal cancer surgery is relatively safe in selected nonagenarian patients and may achieve longterm survival.

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“…For older people, the deterioration is generally recognized in the function of each organ, reserve force, wound healing ability and immunity, which is so-called frailty. 2 Also, they are often accompanied by preoperative comorbidities, such as hypertension, arrhythmia, ischemic heart disease and emphysema. Under such situations, they tend to become serious and have a severe effect on the prognosis, if postoperative complications occur.…”

Section: Introductionmentioning

confidence: 99%

Surgical risk assessment for super‐elderly patients

Miura¹,

Nishio²,

Kitamura³

et al. 2022

Geriatrics Gerontology Int

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Aim Super‐elderly patients are often frail and the decision on surgical indications remains a difficult issue. The purpose of this study was to provide a certain preoperative surgical risk assessment tool for super‐elderly people. Methods We selected 112 individuals who were super‐elderly patients aged >90 years who had surgeries under general anesthesia in our department. Based on the quality of the postoperative outcome of each case, we categorized these patients into two groups: good and poor groups. We evaluated the fundamental examination items, such as American Society of Anesthesiologists physical status, skeletal muscle mass index and so on, and a couple of the well‐known risk score systems represented by Estimation of Physiology Ability and Surgical Stress. Results A total of 85 of the 112 patients belonged to the good group and the rest belonged to the poor group. The quality of postoperative outcome is well characterized by Estimation of Physiology Ability and Surgical Stress (P = 0.001). Receiver operating characteristic analysis of Estimation of Physiology Ability and Surgical Stress for the quality of postoperative outcome shows sensitivity of 0.83 and specificity of 0.61. Multivariate logistic regression analysis showed that skeletal muscle mass index and American Society of Anesthesiologists physical status are prominent as the risk determinants affecting the quality of postoperative outcome. A scoring system based on the skeletal muscle mass index, which is a good index of sarcopenia, and American Society of Anesthesiologists physical status, named the “SAP score” has the following characteristics. P‐value <0.001, sensitivity 0.76 and specificity 0.91. Conclusions Informed consent based on the risk score might be able to reduce the regrettable situation where it would have been better to have had surgery or not to have had surgery. Geriatr Gerontol Int 2022; 22: 271–277.

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The Comprehensive Complication Index is Related to Frailty in Elderly Surgical Patients

Cited by 31 publications

References 37 publications

The association of frailty with olfactory and gustatory dysfunction in older adults: a nationally representative sample

The association of frailty with olfactory and gustatory dysfunction in older adults: a nationally representative sample

Colorectal cancer surgery in selected nonagenarians is relatively safe and it is associated with a good long-term survival: an observational study

Surgical risk assessment for super‐elderly patients

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