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Assessment for frailty is useful for predicting morbidity in elderly patients undergoing colorectal cancer resection whose comorbidities are already optimized.
Am J Surg. 2012 Aug; 204(2):139-43.AJ

Abstract

BACKGROUND

The clinical syndrome of frailty identified through the assessment of weight loss, gait speed, grip strength, physical activity, and physical exhaustion has been used to identify patients with reduced reserves. We hypothesized that frailty is useful in predicting adverse outcomes in optimized elective elderly colorectal surgery patients.

METHODS

A prospective study was conducted at 2 centers (Singapore and Japan). All patients over 75 years of age undergoing colorectal resection were assessed for the presence of the syndrome of frailty. All these patients had already had their comorbidities optimized for surgery. The outcome measure was postoperative major complications (defined as Clavien-Dindo type II and above complications).

RESULTS

Eighty-three patients were studied from February 2008 to April 2010. The mean age was 81.5 years (range 75-93 years). The mean comorbidity index was 3.37 (range 0-11). Twenty-six (31.3%) patients were an American Society of Anesthesiologists (ASA) score of 3 and above. Chi-square analysis revealed that the odds ratio of postoperative major complications was 4.083 (95% confidence interval, 1.433-11.638) when the patient satisfied the criteria for frailty. Albumin <35, ASA >3, comorbidity index >5, and Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scores were not predictive of postoperative major complications.

CONCLUSIONS

Preliminary findings show that frailty is a potent adjunctive tool of predicting postoperative morbidity. Frailty can be used to identify elderly patients needing further optimization before major surgery.

Authors+Show Affiliations

Department of Surgery, Alexandra Health, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, the Republic of Singapore. kokyangtan@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

22178483

Citation

Tan, Kok-Yang, et al. "Assessment for Frailty Is Useful for Predicting Morbidity in Elderly Patients Undergoing Colorectal Cancer Resection Whose Comorbidities Are Already Optimized." American Journal of Surgery, vol. 204, no. 2, 2012, pp. 139-43.
Tan KY, Kawamura YJ, Tokomitsu A, et al. Assessment for frailty is useful for predicting morbidity in elderly patients undergoing colorectal cancer resection whose comorbidities are already optimized. Am J Surg. 2012;204(2):139-43.
Tan, K. Y., Kawamura, Y. J., Tokomitsu, A., & Tang, T. (2012). Assessment for frailty is useful for predicting morbidity in elderly patients undergoing colorectal cancer resection whose comorbidities are already optimized. American Journal of Surgery, 204(2), 139-43. https://doi.org/10.1016/j.amjsurg.2011.08.012
Tan KY, et al. Assessment for Frailty Is Useful for Predicting Morbidity in Elderly Patients Undergoing Colorectal Cancer Resection Whose Comorbidities Are Already Optimized. Am J Surg. 2012;204(2):139-43. PubMed PMID: 22178483.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment for frailty is useful for predicting morbidity in elderly patients undergoing colorectal cancer resection whose comorbidities are already optimized. AU - Tan,Kok-Yang, AU - Kawamura,Yutaka J, AU - Tokomitsu,Aika, AU - Tang,Terence, Y1 - 2011/12/16/ PY - 2011/03/24/received PY - 2011/07/10/revised PY - 2011/08/04/accepted PY - 2011/12/20/entrez PY - 2011/12/20/pubmed PY - 2012/10/25/medline SP - 139 EP - 43 JF - American journal of surgery JO - Am J Surg VL - 204 IS - 2 N2 - BACKGROUND: The clinical syndrome of frailty identified through the assessment of weight loss, gait speed, grip strength, physical activity, and physical exhaustion has been used to identify patients with reduced reserves. We hypothesized that frailty is useful in predicting adverse outcomes in optimized elective elderly colorectal surgery patients. METHODS: A prospective study was conducted at 2 centers (Singapore and Japan). All patients over 75 years of age undergoing colorectal resection were assessed for the presence of the syndrome of frailty. All these patients had already had their comorbidities optimized for surgery. The outcome measure was postoperative major complications (defined as Clavien-Dindo type II and above complications). RESULTS: Eighty-three patients were studied from February 2008 to April 2010. The mean age was 81.5 years (range 75-93 years). The mean comorbidity index was 3.37 (range 0-11). Twenty-six (31.3%) patients were an American Society of Anesthesiologists (ASA) score of 3 and above. Chi-square analysis revealed that the odds ratio of postoperative major complications was 4.083 (95% confidence interval, 1.433-11.638) when the patient satisfied the criteria for frailty. Albumin <35, ASA >3, comorbidity index >5, and Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scores were not predictive of postoperative major complications. CONCLUSIONS: Preliminary findings show that frailty is a potent adjunctive tool of predicting postoperative morbidity. Frailty can be used to identify elderly patients needing further optimization before major surgery. SN - 1879-1883 UR - https://www.unboundmedicine.com/medline/citation/22178483/Assessment_for_frailty_is_useful_for_predicting_morbidity_in_elderly_patients_undergoing_colorectal_cancer_resection_whose_comorbidities_are_already_optimized_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(11)00656-8 DB - PRIME DP - Unbound Medicine ER -