Please use this identifier to cite or link to this item:
http://doi.org/10.25358/openscience-10090
Authors: | Anic, Katharina Varchola, Jakub Schmidt, Mona Wanda Schwab, Roxana Linz, Valerie Catherine Schmidt, Marcus Hardt, Roland Hartmann, Erik Kristoffer Ruckes, Christian Hasenburg, Annette Battista, Marco Johannes |
Title: | Influence of interdisciplinary frailty screening on perioperative complication rates in elderly ovarian cancer patients : results of a retrospective observational study |
Online publication date: | 15-Feb-2024 |
Year of first publication: | 2023 |
Language: | english |
Abstract: | Purpose: Frailty is a frequent and underdiagnosed multidimensional age-related syndrome, involving decreased physiological performance reserves and marked vulnerability against major stressors. To standardize the preoperative frailty assessment and identify patients at risk of adverse surgical outcomes, commonly used global health assessment tools were evaluated. We aimed to assess three interdisciplinary preoperative screening assessments to investigate the influence of frailty status with in-hospital complications irrespective of surgical complexity and radicality in older women with ovarian cancer (OC). Methods: Preoperative frailty status was examined by the G8 geriatric screening tool (G8 Score-geriatric screening), Eastern Cooperative Oncology Group performance status (ECOG PS-oncological screening), and American Society of Anesthesiologists Physical Status System (ASA PS-anesthesiologic screening). The main outcome measures were the relationship between perioperative laboratory results, intraoperative surgical parameters and the incidence of immediate postoperative in-hospital complications with the preoperative frailty status. Results: 116 consecutive women 60 years and older (BMI 24.8 ± 5.2 kg/m2) with OC, who underwent elective oncological surgery in University Medical Center Mainz between 2008 and 2019 were preoperatively classified with the selected global health assessment tools as frail or non-frail. The rate of preoperative anemia (hemoglobin ≤ 12 g/dl) and perioperative transfusions were significantly higher in the G8-frail group (65.9% vs. 34.1%; p = 0.006 and 62.7% vs. 41.8%, p = 0.031; respectively). In addition, patients preoperatively classified as G8-frail exhibited significantly more postoperative clinical in-hospital complications (27.8% vs. 12.5%, p = 0.045) independent of chronological age and BMI. In contrast, ECOG PS and ASA PS did not predict the rates of postoperative complications (all p values > 0.05). After propensity score matching, the complication rate in the G8-frail cohort was approximately 1.7 times more common than in the G8-non-frail cohort. Conclusion: Preoperative frailty assessment with the G8 Score identified elderly women with OC recording a significantly higher rate of postoperative in-hospital complications. In G8-frail patients, preoperative anemia and perioperative transfusions were significantly more recorded, regardless of chronological age, abnormal BMI and surgical complexity. Standardized preoperative frailty assessment should be added to clinical routine care to enhance risk stratification in older cancer individuals for surgical patient-centered decision-making. |
DDC: | 610 Medizin 610 Medical sciences |
Institution: | Johannes Gutenberg-Universität Mainz |
Department: | FB 04 Medizin |
Place: | Mainz |
ROR: | https://ror.org/023b0x485 |
DOI: | http://doi.org/10.25358/openscience-10090 |
Version: | Published version |
Publication type: | Zeitschriftenaufsatz |
Document type specification: | Scientific article |
License: | CC BY |
Information on rights of use: | https://creativecommons.org/licenses/by/4.0/ |
Journal: | Archives of gynecology and obstetrics 307 |
Pages or article number: | 1929 1940 |
Publisher: | Springer Nature |
Publisher place: | Berlin; Heidelberg |
Issue date: | 2023 |
ISSN: | 1432-0711 |
Publisher DOI: | 10.1007/s00404-022-06850-4 |
Appears in collections: | DFG-491381577-H |
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File | Description | Size | Format | ||
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influence_of_interdisciplinar-20240215083421230.pdf | 860.8 kB | Adobe PDF | View/Open |