Journal Browser Advanced Search Help
Journal Browser Advanced search HELP
Ann Coloproctol. 2016 Oct;32(5):161-169. English. Original Article. https://doi.org/10.3393/ac.2016.32.5.161
Lee YH , Oh HK , Kim DW , Ihn MH , Kim JH , Son IT , Kang SI , Kim GI , Ahn S , Kang SB .
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea. kdw@snubh.org
Department of Surgery, Soonchunhyang University Gumi Hospital, Gumi, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Division of Statistics, Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea.
Abstract

PURPOSE: This study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer. METHODS: Elderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA. RESULTS: A total of 240 patients, with a mean age of 76.7 ± 5.2 years, were enrolled. Ninety-five patients (39.6%) were classified as "high-risk" and 99 patients (41.3%) as having postoperative complications. The univariate analysis indicated that risk factors for postoperative complications were age, American Society of Anesthesiologists physical status classification, serum hemoglobin, carcinoembryonic antigen, cancer stage, and "high-risk" status. The multivariable analyses indicated that "high-risk" status (odds ratio, 2.107; 95% confidence interval, 1.168–3.804; P = 0.013) and elevated preoperative carcinoembryonic antigen (odds ratio, 2.561; 95% confidence interval, 1.346–4.871, P = 0.004) were independently associated with postoperative complications. A multivariable analysis of the individual CGA domains indicated that high comorbidities and low activities of daily living were significantly related with postoperative complications. CONCLUSION: A preoperative CGA indicating "high-risk" was associated with major postoperative complications in elderly patients who underwent surgery for colorectal cancer. Thus, using the CGA to identify elderly colorectal-cancer patients who should be given more care during postoperative management may be clinically beneficial.

Copyright © 2019. Korean Association of Medical Journal Editors.