title: Prediction of Postoperative Complications Following Elective Surgery in Elderly Patients with Colorectal Cancer Using the Comprehensive Geriatric Assessment.
abstract: OBJECTIVE
  The study aims to determine whether the Comprehensive Geriatric Assessment (CGA) could predict complications of colorectal cancer (CRC) surgery and identify the problems. So we compared the prognostic value of the CGA with patient characteristics and determined predictive scores.
  
  
  METHODS
  A total of 156 patients aged 75 years and older, who underwent surgery for CRC at Osaka University Hospital, were enrolled. Each patient was examined by the CGA prospectively, and all postoperative complications were obtained from the medical records. The CGA included the Barthel Index (BI), Vitality Index, instrumental activities of daily living (iADL), Mini-Mental State Examination (MMSE) and Geriatric Depression Score (GDS). All elements were retrospectively compared in patients with or without postoperative complications, including delirium, surgical site infection and ileus.
  
  
  RESULTS
  Overall, postoperative complications developed in 76 patients (48.7%). The BI and MMSE were associated with the incidence of complications, and BI, iADL, MMSE and GDS were significantly related with delirium. Multivariate logistic analysis identified the MMSE as a significant determinant of postoperative complications after adjusting for other determined predictive scores including the prognostic nutritional index and performance status.
  
  
  CONCLUSIONS
  The CGA was a useful predictor of postoperative complications in elderly patients when administered before surgery for CRC.
authors.affiliation: Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Yukako
authors.initials: Y
authors.lastname: Mokutani
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Mizushima
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Hiromi
authors.initials: H
authors.lastname: Rakugi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000601:surgery*; D003693:Delirium / Q000209:etiology*; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D045823:Ileus / Q000209:etiology*; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology*