Comprehensive geriatric assessment can predict complications in elderly patients after elective surgery for colorectal cancer: a prospective observational cohort study.
OBJECTIVE
To examine the association between the outcomes of a pre-operative comprehensive geriatric assessment (CGA) and the risk of severe post-operative complications in elderly patients electively operated for colorectal cancer.


METHODS
One hundred seventy-eight consecutive patients ≥ 70 years electively operated for all stages of colorectal cancer were prospectively examined. A pre-operative CGA was performed, and patients were categorized as fit, intermediate, or frail. The main outcome measure was severe complications within 30 days of surgery.


RESULTS
Twenty-one patients (12%) were categorized as fit, 81 (46%) as intermediate, and 76 (43%) as frail. Eighty-three patients experienced severe complications, including three deaths; 7/21 (33%) of fit patients, 29/81 (36%) of intermediate patients and 47/76 (62%) of frail patients (p=0.002). Increasing age and ASA classification were not associated with complications in this series.


CONCLUSIONS
CGA can identify frail patients who have a significantly increased risk of severe complications after elective surgery for colorectal cancer.
Kristjansson
Siri R
SR
Department of Geriatric Medicine, University of Oslo, Oslo University Hospital - Ullevål, 0407 Oslo, Norway. sirikristjansson@gmail.com
Nesbakken
Arild
A
Jordhøy
Marit S
MS
Skovlund
Eva
E
Audisio
Riccardo A
RA
Johannessen
Hans-Olaf
HO
Bakka
Arne
A
Wyller
Torgeir B
TB
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000601:surgery* / Q000628:therapy; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D016896:Treatment Outcome