Long-Term Survival and Risk of Institutionalization in Onco-Geriatric Surgical Patients: Long-Term Results of the PREOP Study.
Aged
Aged, 80 and over
Elective Surgical Procedures
/ mortality
Female
Geriatric Assessment
Humans
Institutionalization
/ statistics & numerical data
Longitudinal Studies
Male
Neoplasms
/ mortality
Postoperative Complications
/ diagnosis
Prospective Studies
Risk Assessment
Survival Rate
/ trends
Time Factors
institutionalization
onco-geriatric patients
postoperative outcome
risk assessment
survival
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
23
07
2019
revised:
30
12
2019
accepted:
16
01
2020
pubmed:
11
3
2020
medline:
3
3
2021
entrez:
11
3
2020
Statut:
ppublish
Résumé
To evaluate long-term survival and institutionalization in onco-geriatric surgical patients, and to analyze the association between these outcomes and a preoperative risk score. Prospective cohort study with long-term follow-up. International and multicenter locations. Patients aged 70 years or older undergoing elective surgery for a malignant solid tumor at five centers (n = 229). We assessed long-term survival and institutionalization using the Preoperative Risk Estimation for Onco-geriatric Patients (PREOP) score, developed to predict the 30-day risk of major complications. The PREOP score collected data about sex, type of surgery, and the American Society for Anesthesiologists classification, as well as the Timed Up & Go test and the Nutritional Risk Screening results. An overall score higher than 8 was considered abnormal. We included 149 women and 80 men (median age = 76 y; interquartile range = 8). Survival at 1, 2, and 5 years postoperatively was 84%, 77%, and 56%, respectively. Moreover, survival at 1 year was worse for patients with a PREOP risk score higher than 8 (70%) compared with 8 or lower (91%). Of those alive at 1 year, 43 (26%) were institutionalized, and by 2 years, almost half of the entire cohort (46%) were institutionalized or had died. A PREOP risk score higher than 8 was associated with increased mortality (hazard ratio = 2.6; 95% confidence interval [CI] = 1.7-4.0), irrespective of stage and age, but not with being institutionalized (odds ratios = 1 y, 1.6 [95% CI = .7-3.8]; 2 y, 2.2 [95% CI = .9-5.5]). A high PREOP score is associated with mortality but not with remaining independent. Despite acceptable survival rates, physical function may deteriorate after surgery. It is imperative to discuss treatment goals and expectations preoperatively to determine if they are feasible. Using the PREOP risk score can provide an objective measure on which to base decisions. J Am Geriatr Soc 68:1235-1241, 2020.
Identifiants
pubmed: 32155289
doi: 10.1111/jgs.16384
pmc: PMC7318670
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1235-1241Informations de copyright
© 2020 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.
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