Effectiveness of frailty screening and perioperative team management of colectomy patients aged 80 years or more

Am J Surg. 2022 Feb;223(2):346-352. doi: 10.1016/j.amjsurg.2021.03.059. Epub 2021 Mar 29.

Abstract

Background: We aimed to clarify usefulness of the modified Frailty Index 11 (mFI-11) for assessing risk of postoperative complications (POCs) and effectiveness of perioperative management team (POMT) intervention for improving postoperative status of frail aged patients requiring colorectal cancer (CRC) surgery.

Methods: We compared, retrospectively, surgical outcomes among 151 consecutive CRC surgery patients aged ≥80 years. Patients were grouped by mFI-11 scores and by POMT intervention (vs. no POMT intervention).

Results: POCs were more prevalent, postoperative stays were longer, and discharge status was poorer among high-risk (mFI-11 ≥ 3/11) patients without POMT intervention than among low-risk (mFI-11 ≤ 2/11) patients (p = 0.04, p = 0.02, p < 0.01). Multiple POCs occurred less frequently and performance of activities of daily living was better for high-risk patients with (vs. those without) POMT intervention (p = 0.04, p = 0.03).

Conclusion: POMT intervention appears beneficial for frail aged patients scheduled for CRC surgery.

Keywords: ADL; Colectomy; Colorectal cancer; Frailty; Team intervention.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Colectomy / adverse effects
  • Frail Elderly
  • Frailty* / complications
  • Frailty* / diagnosis
  • Humans
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Risk Factors