Does Preoperative Comprehensive Geriatric Assessment and Frailty Predict Postoperative Complications?
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ORIGINAL SCIENTIFIC REPORT
Does Preoperative Comprehensive Geriatric Assessment and Frailty Predict Postoperative Complications? Rana Tuna Dogrul1 • Ahmet Bulent Dogrul2 • Ali Konan2 • Omur Caglar3 • Fatih Sumer1 • Hatice Caliskan1 • Muhammet Cemal Kizilarslanoglu1 • Mustafa Kemal Kilic1 • Cafer Balci1 • Gunes Arik1 • Gozde Sengul Aycicek1 • Cemile Ozsurekci1 • Meltem Halil1 • Mustafa Cankurtaran1 • Burcu Balam Yavuz1
Accepted: 17 July 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background The influence of preoperative comprehensive geriatric assessment and frailty on postoperative morbidity, mortality, delirium were examined. Methods A total of 108 patients were evaluated. The Katz Index of Independence in Activities of Daily Living (ADL), the Lawton Brody Instrumental Activities of Daily Living Scale (IADL), the Mini-Nutrition Assessment test (MNA), the Mini-Mental State Examination (MMSE), Yesavage Geriatric Depression Scale (GDS) were performed. Fried Criteria were used to assess physical frailty. We used the Physiological and Operative Severity Scores for the Enumeration of Mortality and Morbidity score (POSSUM), the American Society of Anesthesiologists Score (ASA), and the Charlson Comorbidity Index (CCI) to determine the risk of postoperative morbidity and mortality. Assessment Test for Delirium (4AT) was applied for detection of delirium. Results The median age was 71 years (min–max: 65–84). IADL (p = 0.032), MNA (p = 0.01), MMSE scores (p = 0.026) were found to be significantly lower in patients with morbidity. POSSUM physiology score (p = 0.005), operative score (p = 0.015) and CCI (p = 0.029) were significantly higher in the patients with morbidity. Patients developed morbidity were found to be more frail (p \ 0.001). The patients with delirium were found to have lower IADL (p = 0.049) and MMSE scores (p = 0.004), higher POSSUM physiology score (p = 0.005) and all of them were frail. It was found that frailty (OR = 23.695 95% CI: 6.912–81.231 p \ 0.001), POSSUM operative score (OR:1.118 95% CI: 1.021–1.224 p = 0.016) and preoperative systolic blood pressure (OR:0.937%95 CI: 0.879–0.999 p = 0.048) were independently related factors for postoperative morbidity. Conclusion In our study, CGA and frailty in preoperative period were found to be indicators for postoperative morbidity and delirium.
& Rana Tuna Dogrul [email protected] Ahmet Bulent Dogrul [email protected] Ali Konan [email protected] Omur Caglar [email protected] Fatih Sumer [email protected] Hatice Caliskan [email protected]
Muhammet Cemal Kizilarslanoglu [email protected] Mustafa Kemal Kilic [email protected] Cafer Balci [email protected] Gunes Arik [email protected] Gozde Sengul Aycicek [email protected]
123
World J Surg
Introduction Advanced age may be an independent risk factor for complications, but not an obstacle for surgery [1]. Improvement in surgical and anesthesia techniques increased the expectation of long-term survival for geriatric patients [2]. However, geriatric
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