The Prognostic Value of a Geriatric Risk Score for Older Patients with Colorectal Cancer

Autor: J. M. van der Bol, F. van den Bos, Apollo Pronk, W.H. Steup, E. Souwer, A.H. Schiphorst, Marije E. Hamaker, Johanneke E.A. Portielje, Jan Willem T. Dekker, Esther Bastiaannet, D. Hultink
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Colorectal cancer
Risk management tools
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Internal medicine
medicine
80 and over
Journal Article
Colorectal Surgery/adverse effects
Humans
Delirium/etiology
Survival rate
Geriatric Assessment
Aged
Colorectal Cancer
Aged
80 and over
Colorectal Neoplasms/pathology
Framingham Risk Score
business.industry
Proportional hazards model
Hazard ratio
Delirium
General Medicine
medicine.disease
Elective Surgical Procedures/adverse effects
Prognosis
Confidence interval
Colorectal surgery
Survival Rate
Oncology
Elective Surgical Procedures
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Postoperative Complications/etiology
Surgery
Female
medicine.symptom
Risk assessment
business
Colorectal Neoplasms
Colorectal Surgery
Follow-Up Studies
Zdroj: Annals of Surgical Oncology
Annals of Surgical Oncology, 26(1), 71-78
Annals of Surgical Oncology, x. Elsevier
STARTPAGE=x;TITLE=Annals of Surgical Oncology
Annals of Surgical Oncology, 26(1), 71. Springer New York
ISSN: 1068-9265
Popis: INTRODUCTION:VMS is a Dutch risk assessment tool for hospitalized older adults that includes a short evaluation of four geriatric domains: risk for delirium, risk for undernutrition, risk for physical impairments, and fall risk. We investigated whether the information derived from this tool has prognostic value for outcomes of colorectal surgery.METHODS:All consecutive patients over age 70 years who underwent elective colorectal cancer surgery in three Dutch hospitals (2014-2016) were studied. The presence of risk was scored prior to surgery and per geriatric domain as either 0 (risk absent) or 1 (risk present). The total number of geriatric risk factors was summed. The primary outcome was long-term survival. Secondary outcomes were postoperative complications, including delirium. Cox proportional hazards models were used to evaluate the sumscore and risk factors associated with overall survival.RESULTS:Five hundred fifty patients were included. Median age was 76.5 years, and median follow-up was 870 days. Patients with intermediate (1-2) or high (3-4) sumscore were independently associated with lower overall survival, with hazard ratio (HR) of 1.9 [95% confidence interval (CI) 1.1-3.5; p = 0.03] and 8.7 (95% CI 4.0-19.2; p CONCLUSIONS:This easy-to-use geriatric sumscore has strong associations with long-term outcome and morbidity after colorectal cancer surgery. This information may be included in risk models for morbidity and mortality and can be used in shared decision-making.
Databáze: OpenAIRE
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