title: Comprehensive Geriatric Assessment is a useful predictive tool for postoperative delirium after gastrointestinal surgery in old-old adults.
abstract: OBJECTIVE
  To determine whether carrying out the Comprehensive Geriatric Assessment before operations would be useful for predicting complications, particularly postoperative delirium (POD), in old-old patients.
  
  
  METHODS
  A total of 517 patients aged 75 years and older, who underwent radical surgery for gastrointestinal cancer at Osaka University Hospital, were recruited for this observational study. The Comprehensive Geriatric Assessment components and assessment of performance status were carried out before surgery, and a record of postoperative complications including POD was made prospectively until discharge from hospital. The following morphological and clinical measurements were also obtained from the medical records: age, sex, disease type, previous history, comorbid lifestyle-related diseases, POD, postoperative complications, operative method, duration of operation, hemorrhage volume, blood transfusion volume, method of anesthesia, body mass index and blood tests.
  
  
  RESULTS
  POD appeared in 24.0% of the 517 patients who underwent surgery. Barthel Index, Mini-Mental State Examination, instrumental activities of daily living and Geriatric Depression Scale results were associated with the incidence of POD, and the Barthel Index, Mini-Mental State Examination and Instrumental Activities of Daily Living results were extracted as independent factors associated with the development of POD after adjusting for traditional risk factors for postoperative complications and performance status.
  
  
  CONCLUSIONS
  The Comprehensive Geriatric Assessment before gastrointestinal surgery can be a useful tool for predicting the development of POD in old-old patients. Geriatr Gerontol Int 2016; 16: 1036-1042.
authors: Geriatric Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Yoshihiro
authors: Y
authors: Maekawa
authors: Geriatric Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Ken
authors: K
authors: Sugimoto
authors: Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Makoto
authors: M
authors: Yamasaki
authors: Geriatric Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Yasushi
authors: Y
authors: Takeya
authors: Geriatric Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Koichi
authors: K
authors: Yamamoto
authors: Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors: Mitsuru
authors: M
authors: Ohishi
authors: Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan.
authors: Toshio
authors: T
authors: Ogihara
authors: Clinical Epidemiology and Biostatistics, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Ayumi
authors: A
authors: Shintani
authors: Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Yuichiro
authors: Y
authors: Doki
authors: Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Masaki
authors: M
authors: Mori
authors: Geriatric Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
authors: Hiromi
authors: H
authors: Rakugi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003693:Delirium / Q000175:diagnosis* / Q000453:epidemiology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015577:Geriatric Assessment / Q000379:methods*; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: Comprehensive Geriatric Assessment; gastrointestinal surgery; old-old adults; postoperative complications; postoperative delirium