Poor nutritional status is associated with other geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients – a multicentre cohort study

Huisman, M G, Veronese, G, Audisio, R A, Ugolini, G, Montroni, I, Vigano, A, Gilbert, L, Spiliotis, J, Stabilini, C, de Liguori Carino, N, Farinella, E, Stanojevic, G, Veering, B T, Reed, MW, Somasundar, P S, de Bock, G H and van Leeuwen, B L (2016) Poor nutritional status is associated with other geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients – a multicentre cohort study. European Journal of Surgical Oncology, 42 (7). pp. 1009-1017. ISSN 0748-7983

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Abstract

Background: Nutritional status (NS), though frequently affected in onco-geriatric patients, is no standard
part of a geriatric assessment. The aim of this study was to analyse the association between a preoperatively
impaired NS and geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients.
Methods: 309 patients ≥70 years undergoing surgery for solid tumours were prospectively recruited. Nine screening tools were preoperatively administered as part of a geriatric assessment. NS was based on BMI, weight loss and food intake. Odds ratio’s (OR) and 95% confidence intervals (95%CI) were estimated using logistic regression analysis. The occurrence of 30-day adverse postoperative outcomes was recorded.
Results: At a median age of 76 years, 107 patients (34.6%) had an impaired NS. Decreased performance
status and depression were associated with an impaired NS, when adjusted for tumour characteristics and comorbidities (ORPS>1 3.46; 95%CI 1.56-7.67. ORGDS>5 2.11; 95%CI 1.05-4.26). An impaired NS was an independent predictor for major complications (OR 3.3; 95%CI 1.6-6.8). Ten out of 11 patients who deceased had an impaired NS.
Conclusion: An impaired NS is prevalent in onco-geriatric patients considered to be fit for surgery. It is associated with decreased performance status and depression. An impaired NS is a predictor for adverse postoperative outcomes. NS should be incorporated in a geriatric assessment.

Item Type: Article
Keywords: Nutritional status; Geriatric assessment; Surgery; Postoperative complications; Oncology; Aged
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Subjects: R Medicine > R Medicine (General)
Depositing User: Esme Acton-Stewart
Date Deposited: 22 Apr 2016 11:06
Last Modified: 03 Jul 2017 07:45
URI: http://sro.sussex.ac.uk/id/eprint/60520

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