Clinical scienceAssessment for frailty is useful for predicting morbidity in elderly patients undergoing colorectal cancer resection whose comorbidities are already optimized
Section snippets
Methods
A prospective study was conducted at 2 centers (Singapore and Japan). Consecutive patients over 75 years of age undergoing elective colorectal resection surgery were included in the study. The age cutoff of 75 years was chosen because this age is in line with what we have defined as elderly surgical patients in our other studies.10 Patients over the age of 75 had been shown in some studies to have a higher risk of postoperative complications.11 Patients who declined data collection were
Results
A total of 83 patients over 75 years of age who underwent major colorectal surgery were studied prospectively. Patient demographics are shown in Table 2. More than 90% of patients had associated comorbidities. Nearly one quarter of the patients were positive for the frailty syndrome according to the criteria proposed by Fried et al.9
Complication and mortality rates are also reflected in Table 2. There were an equal number of surgical complications and medical complications. Three patients
Comments
Risk stratification for elderly patients undergoing major surgery is important for surgical planning. Only with proper risk stratification can decisions be made with regard to whether to perform surgery at all, the type of surgery, and the timing of the surgery. Risk stratification will also identify patients who require a period of optimization before surgery. Risk stratification is performed by assessing comorbidities and investigations of biochemical and physiological markers. Because the
Conclusions
Our preliminary findings show that frailty is a potent adjunctive tool of predicting postoperative morbidity. Frailty can be used to identify elderly patients needing further optimization before major surgery.
Acknowledgments
The authors thank Senior Staff Nurse Phyllis Tan, Khoo Teck Puat Hospital, who has contributed to the management of the collected data and the design of the tables.
References (20)
- et al.
Medical considerations in older surgical patients
J Am Coll Surg
(2006) - et al.
Colorectal cancer surgery in the elderly: acceptable morbidity?
Am J Surg
(2008) - et al.
Laparoscopic colorectal surgery in elderly patients: a case-control study of 15 years of experience
Am J Surg
(2011) - et al.
Frailty as a predictor of surgical outcomes in older patients
J Am Coll Surg
(2010) - et al.
The impact of frailty in the elderly on the outcome of surgery in the aged
Adv Surg
(2010) - et al.
Frailty is associated with postoperative complications in older adults with medical problems
Arch Gerontol Geriatr
(2009) - et al.
Colorectal surgery in octogenarian patients—outcomes and predictors of morbidity
Int J Colorectal Dis
(2009) - et al.
Which octogenarians do poorly after major open abdominal surgery in our Asian population?
World J Surg
(2006) - et al.
Optimizing the management of elderly colorectal surgery patients
Surg Today
(2010) - et al.
The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM)
Br J Surg
(2003)
Cited by (196)
Geriatric Assessment in Colorectal Surgery: A Systematic Review
2024, Journal of Surgical ResearchFrailty and Preoperative Palliative Care in Surgical Oncology
2023, Current Problems in CancerPharmacogenomics in gastroenterology
2023, Pharmacogenomics: from Discovery to Clinical ImplementationFrailty assessment has come to stay: Retrospective analysis pilot study of two frailty scales in oncological older patients undergoing colorectal surgery
2023, Revista Espanola de Anestesiologia y Reanimacion