Page 85 - Risk quantification and modification in older patients with colorectal cancer

Appendix A VMS questionnaires
Geriatric risk score and poor surgical outcomes
Risk for delirium
1. Do you have cognitive problems?
2. Did you need help with self-care in
the past 24 hours?
3. Have you experienced an episode of
confusion or delirium before?
Fall risk
1. Did you fall at least once in the last 6 months?
Yes: increased risk for further functional decline
Risk for undernutrition SNAQ
1. Did you lose weight unintentionally?
• ≥6kg in the past 6 months(3)
• ≥3kg in the last month (2)
2. Did you have a reduced appetite last month? (1)
3. Did you take nutritional drinks or did you use a feeding pump last month? (1)
2 points: medium risk : observe intake ≥3 points: high-risk: consult dietician
MUST
1. Calculate body mass index
• >20(0)
• 18.5-20 (1)
• <18.5 (2)
2. Weight loss score in past 3-6 months
• 5%(0)
• 5-10% (1)
• >10% (2)
3. Acute illness and likely to be no nutritional intake for >5 days (2)
1 point: observe intake
≥2 points high-risk: consult dietician
Katz-ADL 6
1. Do you need help with bathing?
2. Do you need help with dressing?
3. Do you need help with using the toilet?
4. Do you need help with eating?
5. Do you need help with a transfer from bed to chair?
6. Do you use incontinence
materials?
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