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

J Geriatr Oncol. 2017 Sep;8(5):320-327. doi: 10.1016/j.jgo.2017.07.008. Epub 2017 Aug 3.


Objectives: This 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 methods: Patients 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.

Results: 190 patients, aged ≥70years, 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.

Conclusion: In 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.

Keywords: Colorectal cancer; Elderly; Geriatric assessment; Geriatric screening; Postoperative complications.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Belgium / epidemiology
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / surgery*
  • Elective Surgical Procedures / adverse effects
  • Elective Surgical Procedures / mortality
  • Female
  • Frail Elderly
  • Geriatric Assessment / methods
  • Humans
  • Length of Stay
  • Male
  • Postoperative Complications / etiology*
  • Postoperative Complications / mortality
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors