title: Pre- and intra-operative variables associated with surgical complications in elderly patients with gynecologic cancer: the clinical value of comprehensive geriatric assessment.
abstract: OBJECTIVE
  The aim of this study is to evaluate the associations of pre- and intra-operative variables including comprehensive geriatric assessment (CGA) with surgical complications in elderly patients who underwent primary surgery for gynecologic cancer.
  
  
  METHODS
  Sixty consecutive patients ≥70years of age who were scheduled to undergo elective surgery for the treatment of gynecologic cancer were preoperatively assessed by CGA. Every category of CGA, performance status (PS), and brief fatigue inventory (BFI) as well as surgical complexity were evaluated for 30-day surgical complications.
  
  
  RESULTS
  The overall postoperative complication rate was 30.0% (18/60) including 9 (15.0%) major and 8 (13.3%) multiple complications. Univariate analysis revealed that dependent instrumental activity of daily living (IADL) was associated with any (p=0.023) and multiple complications (p=0.019). Poor PS was associated with major (p=0.021) and multiple complications (p=0.014). Multivariate logistic regression analysis revealed that high surgical complexity was the most independent predictor of any, major, and multiple complications, whereas poor PS was the independent predictor only for multiple complications (odds ratio 10.7, 95% confidence interval 1.7 to 90.2, p=0.043). There was no CGA component which could independently predict postoperative complications.
  
  
  CONCLUSIONS
  Surgical complexity can predict any, major, and multiple postoperative complications, while PS seems to be useful in predicting multiple complications in elderly patients with gynecologic cancer. In this small study, a CGA was not useful in predicting postoperative complications.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Suh
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: Jae-Weon
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: Hee Seung
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: Hyun Hoon
authors.initials: HH
authors.lastname: Chung
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: Noh Hyun
authors.initials: NH
authors.lastname: Park
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul 110-779, Republic of Korea; WCU Biomodulation Major, Department of Agricultural Biotechnology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-921, Republic of Korea.
authors.forename: Yong Sang
authors.initials: YS
authors.lastname: Song
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D017558:Elective Surgical Procedures / Q000379:methods; D005221:Fatigue / Q000209:etiology; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D015577:Geriatric Assessment / Q000379:methods*; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007430:Intraoperative Care; D017567:Karnofsky Performance Status; D011183:Postoperative Complications / Q000209:etiology*; D011300:Preoperative Care
keywords: Elderly; Geriatric assessments; Gynecologic neoplasms; Postoperative complication