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

ObjectivesThis 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 MethodsPatients 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.Results190 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 (PWald < 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.ConclusionIn 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.