Page 77 - Risk quantification and modification in older patients with colorectal cancer

Geriatric risk score and poor surgical outcomes
characteristics and geriatric parameters. Most patients had laparoscopic surgery (n=436; 79%). Thirty-five patients (6%) had KatzADL score of 2 or higher, and at least one fall in the past 6 months was reported by 76 patients (14%) prior to surgery. For 27 patients (5%), the fall history was unknown. Undernutrition was present in 127 patients (23%), and 106 patients (19%) were at risk for delirium. A total of 303 patients (55%) had low risk sumscore, 220 patients (40%) had intermediate risk sumscore, and 27 patients (5%) had a high risk sumscore.
Primary outcome
Twenty-five patients (5%) died within 6 months after surgery, and 31 patients (6%) died within 1 year. Figure 1 presents the survival analysis is shown for all three risk groups. Patients with intermediate risk sumscore (HR 1.9; 95% CI 1.1-3.5; p=0.03) and high risk sum score, (HR 8.7; 95% CI 4.0-19.2; p<0.001) had significantly lower overall survival. At end of follow-up, 13% (n=29) in the intermediate risk group and 44% (n=12) in the high risk group had died compared with 6% (n=19) in the low risk group.
When analysing the individual domains separately and corrected for age, gender, tumour stage and ASA score, we found that impaired functionality (Katz ≥2), fall risk, and risk for delirium were all associated with overall survival with HR of 4.7 (95% CI 2.5-8.8), 2.6 (95% CI 1.4-4.6) and 2.1 (95% CI 2.0-6.0), respectively. Risk for undernutrition was not independently associated with overall survival (Table 2).
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