Prognostic value of Geriatric-8 for adverse outcomes within 30 days of surgery in older adults with colorectal cancer: A retrospective cohort study

• Published in: European journal of oncology nursing : the official journal of European Oncology Nursing Society Vol. 70; p. 102591
• Main Authors: Winters, A.M., Bakker, J., ten Hoor, J., Bilo, H.J.G., Roodbol, P.F., Edens, M.A., Finnema, E.J.
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01-06-2024
• Subjects: Aged; Aged, 80 and over; Cognitive decline; Cohort Studies; Colorectal Neoplasms - mortality; Colorectal Neoplasms - surgery; Complication; Delirium; Female; Geriatric Assessment; Humans; Male; Mortality; Netherlands; Postoperative Complications - epidemiology; Prognosis; Retrospective Studies; Risk Assessment; Netherlands; Cognitive decline; Delirium; Complication; Geriatric assessment; Mortality
• ISSN: 1462-3889; 1532-2122
• DOI: 10.1016/j.ejon.2024.102591

It is unclear whether the Geriatric-8 (G8) has the accuracy to preselect patients for complete geriatric assessment, and has the ability to predict adverse outcomes in patients with colorectal cancer (CRC). We therefore aimed to determine whether the G8, or other variables present in the medical record, are applicable in predicting 30-day adverse outcomes in older patients undergoing surgery for CRC.
We performed a retrospective cohort study involving patients ≥70 years who had surgery for CRC between 2018 and 2020 in a general hospital in the Netherlands. The primary outcome was adverse outcome(s), which is a composite of surgical and non-surgical complications, readmission and mortality, all within 30 days of surgery. The secondary endpoints were the individual components, such as delirium, infection and ileus. We explored potential prognostic factors using multivariable logistic regression analysis. Data were collected from the Dutch ColoRectal Audit (DRCA) and medical records.
The study included 200 patients (mean age 78.9 years: 50% female), with 36.5% having adverse outcomes in the first 30 days of surgery. In neither univariate nor multivariable analysis were G8 scores associated with adverse outcomes. Factors with higher odds of adverse outcomes were male gender, and having cognitive decline or previous delirium.
This study confirms that G8 scores have no prognostic value for adverse outcomes, complications and mortality within 30 days of surgery among older adults with CRC. Therefore, the G8 should not be the tool for short-term risk prediction of adverse outcomes in these patients.
•G8 scores do not predict adverse outcomes within 30 days after surgery among older adults with CRC.•Male gender, and problems in cognitive functioning are important prognostic factors and should be included in the frailty screening process before surgery.•The development of new frailty screening procedures and their impact on patient and clinical outcomes require further study.