title: Prediction of Postoperative Complications Using Multidimensional Frailty Score in Older Female Cancer Patients with American Society of Anesthesiologists Physical Status Class 1 or 2.
abstract: BACKGROUND
  Even low-risk, elderly patients are at increased risk for postoperative morbidity compared with their younger counterparts. We sought to evaluate the role of a scoring model in predicting adverse surgical outcomes in low-risk, older, female cancer patients.
  
  
  METHODS
  From October 2011 to May 2014, two hundred and eighty-one low-risk female patients (aged 65 years and older, American Society of Anesthesiologists class 1 or 2) undergoing curative cancer surgery were included. The Multidimensional Frailty Score (MFS) was calculated by comprehensive geriatric assessment. The primary end point was postoperative complication (eg, pneumonia, urinary tract infection, delirium, acute pulmonary thromboembolism, and unplanned ICU admission). Secondary outcomes were length of hospital stay and institutionalization.
  
  
  RESULTS
  Twenty patients experienced postoperative complications and 15 patients were discharged to nursing facilities. The fully adjusted odds ratio (OR) per 1-point increase in MFS was 1.412 (95% CI, 1.012-1.969; p = 0.042) for postoperative complications, 1.377 (95% CI, 0.935-2.026; p = 0.105) for institutionalization, and 1.411 (95% CI, 1.110-1.793; p = 0.005) for prolonged hospital stay. The high-risk group (MFS ≥7) showed an increased risk for postoperative complications (OR = 8.513; 95% CI, 2.210-32.785; p = 0.002), institutionalization (OR = 1.291; 95% CI, 0.324-5.152; p = 0.717), and prolonged hospital stay (OR = 2.336; 95% CI, 1.090-5.006; p = 0.029) compared with the low-risk group (MFS <7), after adjusting confounders.
  
  
  CONCLUSIONS
  Multidimensional Frailty Score based on a preoperative comprehensive geriatric assessment is useful for predicting postoperative complications and prolonged hospital stay, even in low-risk elderly women who are undergoing cancer surgery.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Republic of Korea.
authors.forename: Jung-Yeon
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Republic of Korea.
authors.forename: Sol-Ji
authors.initials: SJ
authors.lastname: Yoon
authors.affiliation: Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Sun-Wook
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Republic of Korea.
authors.forename: Hee-Won
authors.initials: HW
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Republic of Korea; Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: kikim907@snu.ac.kr.
authors.forename: Kwang-Il
authors.initials: KI
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seongnam, Republic of Korea; Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Kang
authors.affiliation: Department of Surgery, Breast Care Center, Daerim St. Mary's Hospital, Seoul, Republic of Korea.
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seongnam, Republic of Korea; Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Republic of Korea; Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Cheol-Ho
authors.initials: CH
authors.lastname: Kim
mesh_terms: D000368:Aged; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D009369:Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment