Page 76 - Risk quantification and modification in older patients with colorectal cancer

Chapter 4
In all three hospitals, geriatric information was registered in the EMR prior to surgery for the majority of patients on the day of admission, except for malnutrition, where screening is done shortly after the decision for surgery is made. The information from the VMS does not alter the primary therapeutic plan but is used to guide supportive measures after surgery. For patients with impairments in the individual domains of falls and ADL dependency, this is postoperative mobilisation with physiotherapy. For patients who have undernutrition, dietary support is advised and in case of increased risk for delirium, postoperative monitoring using Delirium Observation Screening Scale11 is advised.
Statistical analysis
We used descriptive analysis expressing normally distributed variables as mean with standard deviation (SD) and nonnormally distributed variables as median with interquartile range (IQR). Frequencies are presented as number and percentage. A chi-squared test was used to compare proportions between the three risk groups.
To assess the prognostic value of the three risk scores on overall survival (OS), a multivariate Cox proportional hazards model was used to estimate hazard ratios (HRs) with corresponding 95% confidence interval (CI). To assess the association between risk factors and postoperative outcomes, multivariate logistic regression models were used to calculate odds ratios (ORs) with corresponding 95% CI. Age, male gender, and tumor stage were considered potential confounders and were added to a multivariate model in addition to ASA score. All analyses were performed using SPSS version 24.0 (SPSS, Inc., Chicago, IL), p-values < 0.05 were considered statistically significant.
Results
A total of 707 patients aged 70 years or older were identified. After excluding 157 patients based on the predefined criteria, 550 patients were included in the analysis of whom 293 (53%) were men.
The median age was 76.5 years (IQR 74.3-82.1 years). Median follow-up was 870 days, and 60 deaths (11%) were registered. Table 1 presents the demographic
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