Department of Geriatric Medicine, University of Oslo, Oslo University Hospital - Ullevål, 0407 Oslo, Norway.
Crit Rev Oncol Hematol. 2010 Dec;76(3):208-17. doi: 10.1016/j.critrevonc.2009.11.002. Epub 2009 Dec 14.
To examine the association between the outcomes of a pre-operative comprehensive geriatric assessment (CGA) and the risk of severe post-operative complications in elderly patients electively operated for colorectal cancer.
One hundred seventy-eight consecutive patients ≥ 70 years electively operated for all stages of colorectal cancer were prospectively examined. A pre-operative CGA was performed, and patients were categorized as fit, intermediate, or frail. The main outcome measure was severe complications within 30 days of surgery.
Twenty-one patients (12%) were categorized as fit, 81 (46%) as intermediate, and 76 (43%) as frail. Eighty-three patients experienced severe complications, including three deaths; 7/21 (33%) of fit patients, 29/81 (36%) of intermediate patients and 47/76 (62%) of frail patients (p=0.002). Increasing age and ASA classification were not associated with complications in this series.
CGA can identify frail patients who have a significantly increased risk of severe complications after elective surgery for colorectal cancer.
探讨术前综合老年评估(CGA)结果与择期接受结直肠癌手术的老年患者发生严重术后并发症风险之间的关系。
前瞻性检查了 178 例年龄≥70 岁、接受所有分期结直肠癌择期手术的连续患者。进行了术前 CGA,并将患者分为健康、中等和虚弱。主要观察指标为术后 30 天内的严重并发症。
21 例(12%)患者被归类为健康,81 例(46%)为中等,76 例(43%)为虚弱。83 例患者发生严重并发症,包括 3 例死亡;健康组 7/21(33%)、中等组 29/81(36%)和虚弱组 47/76(62%)(p=0.002)。在本系列中,年龄增加和 ASA 分级与并发症无关。
CGA 可识别出虚弱患者,他们在择期接受结直肠癌手术后发生严重并发症的风险显著增加。