期刊
JOURNAL OF SURGICAL RESEARCH
卷 193, 期 1, 页码 265-272出版社
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.jss.2014.07.004
关键词
Cancer surgery; Geriatric assessment; Treatment outcome; Survival; Complication
类别
资金
- Medical Student Training in Aging Research program in conjunction with the University Cancer Research Fund
- National Center for Research Resources
- National Center for Advancing Translational Sciences
- National Institutes of Health [KL2TR001109, UL1TR001111]
Background: The comprehensive geriatric assessment (CGA) has developed as an important prognostic tool to risk stratify older adults and has recently been applied to the surgical field. In this systematic review, we examined the utility of CGA components as predictors of adverse outcomes among geriatric patients undergoing major oncologic surgery. Materials and methods: MEDLINE, Embase, and the Cochrane Library were searched for prospective studies examining the association of components of the CGA with specific outcomes among geriatric patients undergoing elective oncologic surgery. Outcome parameters included 30-d postoperative complications (POC), mortality, and discharge to a nonhome institution. Results: The initial search identified 178 potentially relevant articles, with six studies meeting inclusion criteria. Deficiencies in instrumental activities of daily living, activities of daily living, fatigue, cognition, frailty, and cognitive impairment were associated with increased POC. No CGA predictors were identified for postoperative mortality whereas frailty, deficiencies in instrumental activities of daily living, and depression predicted discharge to a nonhome institution. Conclusions: Across a variety of surgical oncologic populations and cancer types, components of the CGA appear to be predictive of POC and discharge to a nonhome institution. These results argue for inclusion of focused geriatric assessments as part of routine pre-operative care in the geriatric surgical oncology population. (C) 2015 Elsevier Inc. All rights reserved.
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