M G Huisman1, G Veronese2, R A Audisio3, G Ugolini2, I Montroni2, G H de Bock4, B L van Leeuwen5. 1. University of Groningen, University Medical Centre Groningen, Department of Surgery, Hanzeplein 1, 9713, GZ Groningen, The Netherlands. Electronic address: m.g.huisman@umcg.nl. 2. University of Bologna, S. Orsola Malpighi Hospital, Department of Surgery, Via Pietro Albertoni, 15, 40138, Bologna, Italy. 3. University of Liverpool, St. Helens Teaching Hospital, Department of Surgery, Marshalls Cross Road, St. Helens, WA9 3DA, United Kingdom. 4. University of Groningen, University Medical Centre Groningen, Department of Epidemiology, Hanzeplein 1, 9713, GZ Groningen, The Netherlands. 5. University of Groningen, University Medical Centre Groningen, Department of Surgery, Hanzeplein 1, 9713, GZ Groningen, The Netherlands.
Abstract
BACKGROUND: Nutritional status (NS), though frequently affected in onco-geriatric patients, is no standard part of a geriatric assessment. The aim of this study was to analyse the association between a preoperatively impaired NS and geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients. METHODS: 309 patients ≥70 years undergoing surgery for solid tumours were prospectively recruited. Nine screening tools were preoperatively administered as part of a geriatric assessment. NS was based on BMI, weight loss and food intake. Odds ratio's (OR) and 95% confidence intervals (95% CI) were estimated using logistic regression analysis. The occurrence of 30-day adverse postoperative outcomes was recorded. RESULTS: At a median age of 76 years, 107 patients (34.6%) had an impaired NS. Decreased performance status and depression were associated with an impaired NS, when adjusted for tumour characteristics and comorbidities (ORPS>1 3.46; 95% CI 1.56-7.67. ORGDS>5 2.11; 95% CI 1.05-4.26). An impaired NS was an independent predictor for major complications (OR 3.3; 95% CI 1.6-6.8). Ten out of 11 patients who deceased had an impaired NS. CONCLUSION: An impaired NS is prevalent in onco-geriatric patients considered to be fit for surgery. It is associated with decreased performance status and depression. An impaired NS is a predictor for adverse postoperative outcomes. NS should be incorporated in a geriatric assessment.
BACKGROUND: Nutritional status (NS), though frequently affected in onco-geriatric patients, is no standard part of a geriatric assessment. The aim of this study was to analyse the association between a preoperatively impaired NS and geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients. METHODS: 309 patients ≥70 years undergoing surgery for solid tumours were prospectively recruited. Nine screening tools were preoperatively administered as part of a geriatric assessment. NS was based on BMI, weight loss and food intake. Odds ratio's (OR) and 95% confidence intervals (95% CI) were estimated using logistic regression analysis. The occurrence of 30-day adverse postoperative outcomes was recorded. RESULTS: At a median age of 76 years, 107 patients (34.6%) had an impaired NS. Decreased performance status and depression were associated with an impaired NS, when adjusted for tumour characteristics and comorbidities (ORPS>1 3.46; 95% CI 1.56-7.67. ORGDS>5 2.11; 95% CI 1.05-4.26). An impaired NS was an independent predictor for major complications (OR 3.3; 95% CI 1.6-6.8). Ten out of 11 patients who deceased had an impaired NS. CONCLUSION: An impaired NS is prevalent in onco-geriatric patients considered to be fit for surgery. It is associated with decreased performance status and depression. An impaired NS is a predictor for adverse postoperative outcomes. NS should be incorporated in a geriatric assessment.
Authors: Monique G Huisman; Federico Ghignone; Giampaolo Ugolini; Grigory Sidorenkov; Isacco Montroni; Antonio Vigano; Nicola de Liguori Carino; Eriberto Farinella; Roberto Cirocchi; Riccardo A Audisio; Geertruida H de Bock; Barbara L van Leeuwen Journal: J Am Geriatr Soc Date: 2020-03-10 Impact factor: 5.562