Value of geriatric screening and assessment in predicting postoperative complications in patients older than 70 years undergoing surgery for colorectal cancer

Objectives: This study examines the association between geriatric screening and geriatric assessment (GA) and the risk of 30-day postoperative complications (30d-POCs) in older patients undergoing surgery for colorectal cancer (CRC). Materials and Methods: Patients were identified from a prospectively collected database (2009-2015). All patients underwent geriatric-screening with the G8 screening tool and the Flemish version of the Triage Risk Screening Tool (fTRST). The patients with an abnormal G8 score (G8 <= 14) received a GA, including living situation, basic and instrumental activities of daily living (ADL and I-ADL), falls, fatigue, cognition, depression, nutrition, comorbidities, and polypharmacy. 30d-POCs were retrospectively collected from the medical records and classified into Clavien-Dindo severity grades. The primary endpoint was the occurrence of Clavien-Dindo grade 2 and above (CD >= 2) 30d-POCs. To identify predictive variables, logistic regression analyses were used. Results: 190 patients, aged >= 70 years, were included. Seventy-eight (41.1%) had CD >= 2 30d-POCs, and the 30-day mortality was 1.6%. In univariable logistic regressions, the following variables were associated with CD 2 30d-POCs (P-waid < 0.05): age, G8, ECOG-performance status (ECOG-PS), tumor location, and surgical approach. Age and surgical approach independently predicted 30d-POCs. In the G8 <= 14 patients (receiving a complete GA, n = 115), ADL was the only GA variable associated with CD >= 2 30d-POCs. Conclusion: In this study examining the predictive value of geriatric screening and GA in predicting CD >= 2 30d-POCs, the G8 screening tool was associated in univariable analysis, but did not remain in multivariable analysis. In the G8 <= 14 group receiving GA, ADL was the only predictive GA variable. (C) 2017 Elsevier Ltd. All rights reserved.