What is related to postoperative outcome of frail status in elective colorectal cancer surgery?

Koichi Tamura, MD, PhD; Kenji Matsuda, MD, PhD; Yoichi Fujita, MD; Satoru Sakaguchi, MD, PhD; Hiroyuki Kinoshita, MD, PhD; Naohisa Yamade, MD, PhD; Tsukasa Hotta, MD, PhD; Hiromitsu Iwamoto, MD, PhD; Yuki Mizumoto, MD, PhD; Hiroki Yamaue, MD, PhD

Surgery Open Science (Apr 2022)

What is related to postoperative outcome of frail status in elective colorectal cancer surgery?

Koichi Tamura, MD, PhD,
Kenji Matsuda, MD, PhD,
Yoichi Fujita, MD,
Satoru Sakaguchi, MD, PhD,
Hiroyuki Kinoshita, MD, PhD,
Naohisa Yamade, MD, PhD,
Tsukasa Hotta, MD, PhD,
Hiromitsu Iwamoto, MD, PhD,
Yuki Mizumoto, MD, PhD,
Hiroki Yamaue, MD, PhD

Affiliations

Koichi Tamura, MD, PhD: Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera Wakayama, Wakayama, Japan; Department of Surgery, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashimachi, Kawachinagano, Osaka, Japan
Kenji Matsuda, MD, PhD: Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera Wakayama, Wakayama, Japan
Yoichi Fujita, MD: Department of Surgery, National Hospital Organization Osaka Minami Medical Center, 2-1 Kidohigashimachi, Kawachinagano, Osaka, Japan
Satoru Sakaguchi, MD, PhD: Department of Surgery, Wakayama Rosai Hospital, 93-1 Kinomoto, Wakayama, Wakayama, Japan
Hiroyuki Kinoshita, MD, PhD: Department of Surgery, Naga Municipal Hospital, 1282 Uchida, Kinokawa, Wakayama, Japan
Naohisa Yamade, MD, PhD: Department of Surgery, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, Wakayama, Japan
Tsukasa Hotta, MD, PhD: Department of Surgery, National Hospital Organization Minami Wakayama Medical Center, 27-1 Takinaicho, Tanabe, Wakayama, Japan
Hiromitsu Iwamoto, MD, PhD: Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera Wakayama, Wakayama, Japan
Yuki Mizumoto, MD, PhD: Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera Wakayama, Wakayama, Japan
Hiroki Yamaue, MD, PhD: Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera Wakayama, Wakayama, Japan; Corresponding author at: Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Wakayama, Japan. Tel.: +81-73-441-0613; fax: +81-73-446-6566.

Journal volume & issue: Vol. 8
pp. 69 – 74

Abstract

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Background: The population affected by colorectal cancer is growing, and there is an increasing need for prevention of functional decline following treatment. We proposed that the Kihon Checklist published by the Japanese Ministry of Health, Labor, and Welfare would be an appropriate means of frailty assessment for prediction of postoperative complications in older patients with colorectal cancer. This prospective cohort study aims to identify the factors influencing postoperative frailty. Methods: We prospectively enrolled consecutive patients with colorectal cancer and aged ≥65 year (N = 500) between May 2017 and December 2018. Eligible patients were assessed with the Kihon Checklist prior to surgery and 30 days after surgery. The main measures were variables related to postoperative change in view of frail status. Results: According to the Kihon Checklist questionnaire, 164 patients were frail preoperatively and 172 patients were frail postoperatively, whereas 38 patients changed from ''nonfrail'' before surgery to postoperative ''frail.'' Overall complications were counted in 97 patients (19.4%), and 5 patients died. Performance status ≥ 2, history of laparotomy, open surgery, complication, ostomy creation, and delirium were significantly associated with changing postoperative ''frail'' (P = .014, P = .023, P = .006, P < .001, P = .023, and P = .024, respectively). In multivariate analysis, independent related factors of changing postoperative ''frail'' were complication (odds ratio 2.69, 95% confidence interval 1.19–6.09, P = .018) and ostomy creation (odds ratio 2.32, 95% confidence interval 1.01–5.33, P = .047). Conclusion: The Kihon Checklist questionnaire could identify the factors related to postoperative change of frailty status in older patients with colorectal cancer. This cohort concluded that whether postoperative complication occurred or not was closely associated with perioperative change of frailty status.

Published in Surgery Open Science

ISSN: 2589-8450 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://www.journals.elsevier.com/surgery-open-science/

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