title: Poor nutritional status is associated with other geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients - A multicentre cohort study.
abstract: Nutritional status (NS), though frequently affected in onco-geriatric patients, is no standard part of a geriatric assessment. The aim of this study was to analyse the association between a preoperatively impaired NS and geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients.
  
  
  
  309 patients ≥70 years undergoing surgery for solid tumours were prospectively recruited. Nine screening tools were preoperatively administered as part of a geriatric assessment. NS was based on BMI, weight loss and food intake. Odds ratio's (OR) and 95% confidence intervals (95% CI) were estimated using logistic regression analysis. The occurrence of 30-day adverse postoperative outcomes was recorded.
  
  
  
  At a median age of 76 years, 107 patients (34.6%) had an impaired NS. Decreased performance status and depression were associated with an impaired NS, when adjusted for tumour characteristics and comorbidities (ORPS>1 3.46; 95% CI 1.56-7.67. ORGDS>5 2.11; 95% CI 1.05-4.26). An impaired NS was an independent predictor for major complications (OR 3.3; 95% CI 1.6-6.8). Ten out of 11 patients who deceased had an impaired NS.
  
  
  
  An impaired NS is prevalent in onco-geriatric patients considered to be fit for surgery. It is associated with decreased performance status and depression. An impaired NS is a predictor for adverse postoperative outcomes. NS should be incorporated in a geriatric assessment.
authors.affiliation: University of Groningen, University Medical Centre Groningen, Department of Surgery, Hanzeplein 1, 9713, GZ Groningen, The Netherlands. Electronic address: m.g.huisman@umcg.nl.
authors.forename: M G
authors.initials: MG
authors.lastname: Huisman
authors.affiliation: University of Bologna, S. Orsola Malpighi Hospital, Department of Surgery, Via Pietro Albertoni, 15, 40138, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Veronese
authors.affiliation: University of Liverpool, St. Helens Teaching Hospital, Department of Surgery, Marshalls Cross Road, St. Helens, WA9 3DA, United Kingdom.
authors.forename: R A
authors.initials: RA
authors.lastname: Audisio
authors.affiliation: University of Bologna, S. Orsola Malpighi Hospital, Department of Surgery, Via Pietro Albertoni, 15, 40138, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ugolini
authors.affiliation: University of Bologna, S. Orsola Malpighi Hospital, Department of Surgery, Via Pietro Albertoni, 15, 40138, Bologna, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Montroni
authors.affiliation: University of Groningen, University Medical Centre Groningen, Department of Epidemiology, Hanzeplein 1, 9713, GZ Groningen, The Netherlands.
authors.forename: G H
authors.initials: GH
authors.lastname: de Bock
authors.affiliation: University of Groningen, University Medical Centre Groningen, Department of Surgery, Hanzeplein 1, 9713, GZ Groningen, The Netherlands.
authors.forename: B L
authors.initials: BL
authors.lastname: van Leeuwen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology / Q000601:surgery*; D009426:Netherlands; D009752:Nutritional Status; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D006113:United Kingdom
keywords: Aged; Geriatric assessment; Nutritional status; Oncology; Postoperative complications; Surgery