Dong Hoon Suh1, Jae-Weon Kim2, Hee Seung Kim2, Hyun Hoon Chung2, Noh Hyun Park2, Yong Sang Song3. 1. Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea. 2. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. 3. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul 110-779, Republic of Korea; WCU Biomodulation Major, Department of Agricultural Biotechnology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-921, Republic of Korea.
Abstract
OBJECTIVE: The aim of this study is to evaluate the associations of pre- and intra-operative variables including comprehensive geriatric assessment (CGA) with surgical complications in elderly patients who underwent primary surgery for gynecologic cancer. METHODS: Sixty consecutive patients ≥70years of age who were scheduled to undergo elective surgery for the treatment of gynecologic cancer were preoperatively assessed by CGA. Every category of CGA, performance status (PS), and brief fatigue inventory (BFI) as well as surgical complexity were evaluated for 30-day surgical complications. RESULTS: The overall postoperative complication rate was 30.0% (18/60) including 9 (15.0%) major and 8 (13.3%) multiple complications. Univariate analysis revealed that dependent instrumental activity of daily living (IADL) was associated with any (p=0.023) and multiple complications (p=0.019). Poor PS was associated with major (p=0.021) and multiple complications (p=0.014). Multivariate logistic regression analysis revealed that high surgical complexity was the most independent predictor of any, major, and multiple complications, whereas poor PS was the independent predictor only for multiple complications (odds ratio 10.7, 95% confidence interval 1.7 to 90.2, p=0.043). There was no CGA component which could independently predict postoperative complications. CONCLUSION: Surgical complexity can predict any, major, and multiple postoperative complications, while PS seems to be useful in predicting multiple complications in elderly patients with gynecologic cancer. In this small study, a CGA was not useful in predicting postoperative complications.
OBJECTIVE: The aim of this study is to evaluate the associations of pre- and intra-operative variables including comprehensive geriatric assessment (CGA) with surgical complications in elderly patients who underwent primary surgery for gynecologic cancer. METHODS: Sixty consecutive patients ≥70years of age who were scheduled to undergo elective surgery for the treatment of gynecologic cancer were preoperatively assessed by CGA. Every category of CGA, performance status (PS), and brief fatigue inventory (BFI) as well as surgical complexity were evaluated for 30-day surgical complications. RESULTS: The overall postoperative complication rate was 30.0% (18/60) including 9 (15.0%) major and 8 (13.3%) multiple complications. Univariate analysis revealed that dependent instrumental activity of daily living (IADL) was associated with any (p=0.023) and multiple complications (p=0.019). Poor PS was associated with major (p=0.021) and multiple complications (p=0.014). Multivariate logistic regression analysis revealed that high surgical complexity was the most independent predictor of any, major, and multiple complications, whereas poor PS was the independent predictor only for multiple complications (odds ratio 10.7, 95% confidence interval 1.7 to 90.2, p=0.043). There was no CGA component which could independently predict postoperative complications. CONCLUSION: Surgical complexity can predict any, major, and multiple postoperative complications, while PS seems to be useful in predicting multiple complications in elderly patients with gynecologic cancer. In this small study, a CGA was not useful in predicting postoperative complications.
Authors: Jennifer Watt; Andrea C Tricco; Catherine Talbot-Hamon; Ba' Pham; Patricia Rios; Agnes Grudniewicz; Camilla Wong; Douglas Sinclair; Sharon E Straus Journal: BMC Med Date: 2018-01-12 Impact factor: 8.775
Authors: Jennifer Watt; Andrea C Tricco; Catherine Talbot-Hamon; Ba' Pham; Patricia Rios; Agnes Grudniewicz; Camilla Wong; Douglas Sinclair; Sharon E Straus Journal: J Gen Intern Med Date: 2018-01-26 Impact factor: 5.128