Preoperative geriatric assessment and follow up of patients older than 75 years undergoing elective surgery for suspected colorectal cancer.
OBJECTIVES We investigated the predictive value of specific tools used in a Comprehensive Geriatric Assessment (CGA) with regard to postoperative outcome in patients 75 years and older undergoing elective colorectal cancer (CRC) surgery. Furthermore, recovery was followed over the first postoperative year using the same assessment tools. MATERIAL AND METHODS Baseline clinical and CGA variables including functional and nutritional status, pressure sore risk, fall risk, cognition, depression, polypharmacy, comorbidity, and health related quality of life (HRQoL) were prospectively recorded. Outcome variables were postoperative complications and length of stay (LOS) Patients were likewise followed up at one, three and twelve months postoperatively. RESULTS Forty nine patients underwent surgery (median age 81 years) Forty three per cent had ASA (American Society of Anesthesiologists) class 2 47% had ASA class 3. Postoperative complications occurred in 32.7% Median LOS was eight days. In univariate analyses, none of the parameters tested predicted postoperative complication or LOS. During follow up, all patients recovered to baseline values apart from HRQoL which was still reduced at three and twelve months (p .017) Nutritional status had improved twelve months after surgery (p .011) CONCLUSIONS No association could be found in this study between the results of a comprehensive geriatric assessment and prolonged length of stay or postoperative complication rate after elective surgery for colorectal cancer. Patients recovered well during the first year after surgery. Quality of life, however, was still lower than prior to surgery.
Journal of geriatric oncology