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Evaluation of preoperative geriatric assessment of elderly patients with colorectal carcinoma. A retrospective study.
Eur J Surg Oncol 2015; 41(1):21-7EJ

Abstract

AIMS

Elderly patients with colorectal carcinoma are screened with the Identification of Seniors at Risk (ISAR) questionnaire to identify frail patients. These patients are more at risk for mortality and morbidity and are referred to the geriatric specialist for assessment (Dutch acronym: DOG). The DOG assessment aims to preoperatively optimize the patient in order to improve postoperative outcomes. This study evaluates if the DOG assessment influences postoperative outcome after colorectal surgery.

METHODS

Retrospective cohort and match-control study. Elderly patients who underwent elective resection between 01-01-2008 and 01-08-2013 in the Medical Centre Alkmaar were included. Patients with a positive ISAR score were referred to the geriatric specialists for DOG assessment (DOG patients). DOG assessment encompassed comprehensive geriatric assessment and interventions.

PRIMARY OUTCOMES

Mortality, delirium and length of hospital stay.

SECONDARY OUTCOMES

postoperative complications.

COHORT COMPARISON

Cohort ISAR- (2008-2010, no ISAR questionnaire) is compared with cohort ISAR+ (2011-2013, ISAR questionnaire). Match-control comparison: DOG patients are compared with matched controls from cohort ISAR-.

RESULTS

Compared to their matched controls, DOG patients were older and had a higher prevalence of certain risk factors for postoperative delirium. In both comparisons, no statistical significant differences were found between the groups in mortality and postoperative delirium. Length of stay was significantly shorter in cohort ISAR+.

CONCLUSIONS

While the DOG patients were significantly more at risk for postoperative complications, the DOG patients had comparable postoperative outcomes as their matched controls. We therefore conclude that the DOG assessment has a positive influence on the postoperative outcomes after colorectal surgery.

Authors+Show Affiliations

Department of Surgery, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands. Electronic address: r.indrakusuma@mca.nl.Department of Surgery, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands.Department of Geriatric Medicine, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands.Department of Surgery, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands.

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

25267000

Citation

Indrakusuma, R, et al. "Evaluation of Preoperative Geriatric Assessment of Elderly Patients With Colorectal Carcinoma. a Retrospective Study." European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, vol. 41, no. 1, 2015, pp. 21-7.
Indrakusuma R, Dunker MS, Peetoom JJ, et al. Evaluation of preoperative geriatric assessment of elderly patients with colorectal carcinoma. A retrospective study. Eur J Surg Oncol. 2015;41(1):21-7.
Indrakusuma, R., Dunker, M. S., Peetoom, J. J., & Schreurs, W. H. (2015). Evaluation of preoperative geriatric assessment of elderly patients with colorectal carcinoma. A retrospective study. European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 41(1), pp. 21-7. doi:10.1016/j.ejso.2014.09.005.
Indrakusuma R, et al. Evaluation of Preoperative Geriatric Assessment of Elderly Patients With Colorectal Carcinoma. a Retrospective Study. Eur J Surg Oncol. 2015;41(1):21-7. PubMed PMID: 25267000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of preoperative geriatric assessment of elderly patients with colorectal carcinoma. A retrospective study. AU - Indrakusuma,R, AU - Dunker,M S, AU - Peetoom,J J, AU - Schreurs,W H, Y1 - 2014/09/18/ PY - 2014/02/11/received PY - 2014/07/22/revised PY - 2014/09/08/accepted PY - 2014/10/1/entrez PY - 2014/10/1/pubmed PY - 2015/3/19/medline KW - Aged KW - Colorectal neoplasms KW - Delirium KW - Frail elderly KW - Geriatric assessment KW - Mortality SP - 21 EP - 7 JF - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology JO - Eur J Surg Oncol VL - 41 IS - 1 N2 - AIMS: Elderly patients with colorectal carcinoma are screened with the Identification of Seniors at Risk (ISAR) questionnaire to identify frail patients. These patients are more at risk for mortality and morbidity and are referred to the geriatric specialist for assessment (Dutch acronym: DOG). The DOG assessment aims to preoperatively optimize the patient in order to improve postoperative outcomes. This study evaluates if the DOG assessment influences postoperative outcome after colorectal surgery. METHODS: Retrospective cohort and match-control study. Elderly patients who underwent elective resection between 01-01-2008 and 01-08-2013 in the Medical Centre Alkmaar were included. Patients with a positive ISAR score were referred to the geriatric specialists for DOG assessment (DOG patients). DOG assessment encompassed comprehensive geriatric assessment and interventions. PRIMARY OUTCOMES: Mortality, delirium and length of hospital stay. SECONDARY OUTCOMES: postoperative complications. COHORT COMPARISON: Cohort ISAR- (2008-2010, no ISAR questionnaire) is compared with cohort ISAR+ (2011-2013, ISAR questionnaire). Match-control comparison: DOG patients are compared with matched controls from cohort ISAR-. RESULTS: Compared to their matched controls, DOG patients were older and had a higher prevalence of certain risk factors for postoperative delirium. In both comparisons, no statistical significant differences were found between the groups in mortality and postoperative delirium. Length of stay was significantly shorter in cohort ISAR+. CONCLUSIONS: While the DOG patients were significantly more at risk for postoperative complications, the DOG patients had comparable postoperative outcomes as their matched controls. We therefore conclude that the DOG assessment has a positive influence on the postoperative outcomes after colorectal surgery. SN - 1532-2157 UR - https://www.unboundmedicine.com/medline/citation/25267000/Evaluation_of_preoperative_geriatric_assessment_of_elderly_patients_with_colorectal_carcinoma__A_retrospective_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0748-7983(14)01091-9 DB - PRIME DP - Unbound Medicine ER -