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The Prognostic Value of a Geriatric Risk Score for Older Patients with Colorectal Cancer
E T D Souwer1, D Hultink2, E Bastiaannet3,4
1Department of Internal Medicine, Haga Hospital, PO Box 40551, 2504 LN, The Hague, The Netherlands. e.souwer@hagaziekenhuis.nl.
Annals of Surgical Oncology
|October 27, 2018
Summary
The Geriatric Risk Score tool effectively predicts outcomes in older adults undergoing colorectal surgery. Higher scores indicate increased risk for mortality and complications, aiding in surgical decision-making.
Area of Science:
- Geriatric Medicine
- Surgical Oncology
- Health Services Research
Background:
- The Dutch Visitors Management System (VMS) tool assesses geriatric risks in hospitalized older adults.
- These risks include delirium, undernutrition, physical impairments, and falls.
- The prognostic value of VMS for colorectal surgery outcomes was unexplored.
Purpose of the Study:
- To investigate the prognostic value of the VMS geriatric risk assessment tool.
- To determine if VMS information predicts outcomes in older adults undergoing colorectal surgery.
Main Methods:
- A cohort of 550 patients aged 70+ undergoing elective colorectal cancer surgery was studied (2014-2016).
- Preoperative risk was scored for four geriatric domains (delirium, undernutrition, physical impairments, falls).
- Cox proportional hazards models analyzed the association of the sumscore and individual risk factors with survival and complications.
Main Results:
- Patients with intermediate (1-2) or high (3-4) VMS sumscores had significantly lower overall survival.
- Higher sumscores were independently associated with increased risk of mortality (HR 1.9-8.7).
- VMS sumscores also correlated with higher rates of postoperative complications, including delirium (OR 1.8-2.4).
Conclusions:
- The VMS geriatric sumscore is a strong predictor of long-term outcomes and morbidity after colorectal cancer surgery.
- This easily applicable tool can enhance risk stratification models for surgical patients.
- VMS data can support shared decision-making processes for elderly patients considering colorectal surgery.
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