Page 59 - Risk quantification and modification in older patients with colorectal cancer

Risk stratification using ISAR-HP and G8 screening tools
screened patients other than a slightly higher age (77.7 years versus 75.5 years p= 0.01), a more frequent a history of falls (p= 0.02) and more cognitive impairment (p= 0.02). Please see Appendix C for a more detailed comparison between screened en non-screened patients.
Frailty assessment
Sixty-eight (50%) were classified as frail based on G8 (G8-frail), and 32 (23%) based on ISAR-HP (ISAR-HP-frail), 48 patients (35%) who were classified as frail on G8 were classified as non-frail on the ISAR-HP. Eleven patients (8%) who were classified as frail on the ISAR-HP were non-frail according to the G8 screening tool. Twenty patients (15%) were classified as frail on both the G8 and ISAR-HP. ISAR-HP-frail patients were significantly older (79.8 versus 76.3) had more comorbidities (50% versus 31%), were more ADL dependent (25% versus 4%), they used more often a walking device (63% versus 4%) and reported more falls in the six months prior to surgery (23% versus 4%). There was no significant difference between the number of frail patients (on one or both screening tools) receiving neoadjuvant radiotherapy or adjuvant chemotherapy compared to non- frail patients.
Primary and secondary outcomes
Fifty-one patients (37%) had one or more postoperative complications within 30 days of surgery; twenty-four patients had one or more surgical complications; this required an intervention in ten patients. Anastomotic leakage was reported in seven patients (5%). Twenty-six patients (19%) had a non-surgical complication: ten cardiopulmonary, two neurological, ten infectious and 20 ‘other’ events were registered. Seven patients (5%) a delirium and thirteen patients (9%) were readmitted within 30-days of surgery. Analysis of the 20 ‘other’ events showed that nine consisted of postoperative urinary retention, six were an ileus with recovery after conservative treatment, two were acute renal failure, one non-specific abdominal pain, one anxiety episode requiring psychiatric medication and one a hypocalcaemia.
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