Short- and long-term predictive power of the preoperative Geriatric Assessment components in older cancer patients undergoing high-risk abdominal surgery

2022 ◽  
Author(s):  
Jakub Kenig ◽  
Kinga Szabat ◽  
Jerzy Mituś ◽  
Tomasz Rogula ◽  
Jerzy Krzeszowiak
Keyword(s):  
High Risk ◽  
Abdominal Surgery ◽  
Cancer Patients ◽  
Geriatric Assessment ◽  
Predictive Power ◽  
Short And Long Term ◽  
Older Cancer Patients

scholarly journals SMASH standardised perioperative management of patients operated with acute abdominal surgery in a high-risk setting

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Terje Jansson Timan ◽  
Ninni Sernert ◽  
Ove Karlsson ◽  
Mattias Prytz
Keyword(s):  
High Risk ◽  
Abdominal Surgery ◽  
Perioperative Management ◽  
Demographic Data ◽  
Routine Care ◽  
Outcome Data ◽  
Emergency Laparotomy ◽  
Inclusion Rate ◽  
Short And Long Term

Abstract Objective of the study Emergency laparotomy and other high-risk acute abdominal surgery procedures have a high mortality rate. The perioperative management of these patients is complex and poses several challenges. The objective of the study is to implement and evaluate the outcome of protocol-based standardised care for patients in need of acute abdominal surgery in a Swedish setting. NÄL is a large county hospital in Sweden serving a population of approximately 270,000 inhabitants. The study seeks to determine whether standardised protocol-based perioperative management in emergency abdominal surgical procedures leads to a better outcome measured as short- and long-term mortality and postoperative complications compared with the present standard in Swedish routine care. The study is ongoing, and this article describes the methodology used in the study and discusses the benefits and limitations the study design. Results There are no results so far. The inclusion rate for the first 22 months is as expected; 404 patients have been included and protocols have been followed and reviewed according to the study plan. 25 patients have been missed and demographic data and outcome data for these patients will be collected and analysed.

Trends in short-term, long-term, and high-risk opioid use among older cancer patients.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 187-187
Author(s):  
Mia A Salans ◽  
Paul Riviere ◽  
Lucas Vitzthum ◽  
Vinit Nalawade ◽  
James Don Murphy
Keyword(s):  
High Risk ◽  
Cancer Patients ◽  
Multivariable Analysis ◽  
Opioid Use ◽  
Short Term ◽  
Opioid Prescription ◽  
Cancer Risk Factors ◽  
Older Cancer Patients ◽  
To Receive

187 Background: While opioids represent a cornerstone of cancer pain management, the timing and patterns of persistent and high-risk opioid use in the context of the ongoing opioid epidemic are not well studied. This study sought to explore longitudinal trends in short-term, long-term, and high-risk opioid use among older cancer patients. Methods: Within a cohort of 84,994 Medicare beneficiaries ≥ 65 years old diagnosed with cancer between 2007 and 2013, we determined the likelihood of being prescribed an opioid after cancer diagnosis (0-6 months, 6-12 months, and 1-2 years post-diagnosis) and of receiving a daily morphine equivalent dose (MED) ≥ 200 mg, a dose associated with higher opioid-related mortality. Multivariable logistic regression models were used to identify patient and cancer risk factors associated with outcomes. Results: The rates of opioid prescription at 0 to 6 months, 6 to 12 months, and 1 to 2 years after diagnosis were 60.7%, 32.7%, and 38.2% respectively. Among patients who were prescribed an opioid, 4.0% received a MED ≥ 200 mg within 2 years of diagnosis. The likelihood of opioid prescription 0 to 6 months after diagnosis increased over the study period (OR = 1.05 per year, CI = 1.04 to 1.06), while the likelihood of opioid prescription 6 to 12 months (OR = 0.98 per year, CI = 0.97 to 0.99) and 1 to 2 years (OR = 0.98 per year, CI = 0.97 to 0.99) after diagnosis decreased over the study period. The probability of receiving a MED ≥ 200 mg decreased over the study period (OR = 0.98 per year, CI = 0.96 to 0.99). On multivariable analysis, Black (OR = 1.14, CI = 1.06 to 1.23) and American Indian/Native Alaskan (OR = 1.46, CI = 1.06 to 2.02) patients were more likely to receive opioids 1 to 2 years after diagnosis. Patients living in areas with higher rates of poverty (OR = 1.40, CI = 1.32 to 1.48) were also more likely to receive an opioid 1 to 2 years after diagnosis. Black (OR = 1.72, CI = 1.59 to 1.86), Asian (OR = 1.46, CI = 1.19 to 1.80), and Hispanic (OR = 1.36, CI = 1.23 to 1.51) patients were more likely to receive a MED ≥ 200 mg. Conclusions: While the rate of short-term opioid use is rising, rates of persistent and high-risk opioid use are declining among cancer patients. This may reflect growing awareness of the dangers of opioid misuse among clinicians treating patients with cancer. Nevertheless, racial and socioeconomic disparities in patterns of opioid use are persistent in the cancer population.

scholarly journals Short- and long-term outcomes of local excision with adjuvant radiotherapy in high-risk T1 rectal cancer patients

2022 ◽  
Vol 102 (1) ◽  
pp. 36
Author(s):  
Abdullah Al-Sawat ◽  
Jung Hoon Bae ◽  
Hyun Ho Kim ◽  
Chul Seung Lee ◽  
Seung Rim Han ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
High Risk ◽  
Cancer Patients ◽  
Local Excision ◽  
Adjuvant Radiotherapy ◽  
Long Term Outcomes ◽  
T1 Rectal Cancer ◽  
Short And Long Term

scholarly journals Perioperative use of serum creatinine and postoperative acute kidney injury: a single-centre, observational retrospective study to explore physicians’ perception and practice

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gianluca Villa ◽  
Silvia De Rosa ◽  
Caterina Scirè Calabrisotto ◽  
Alessandro Nerini ◽  
Thomas Saitta ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Retrospective Study ◽  
High Risk ◽  
Abdominal Surgery ◽  
Serum Creatinine ◽  
Malignant Disease ◽  
Kidney Injury ◽  
Major Surgery ◽  
Single Centre

Abstract Background Postoperative acute kidney injury (PO-AKI) is a leading cause of short- and long-term morbidity and mortality, as well as progression to chronic kidney disease (CKD). The aim of this study was to explore the physicians’ attitude toward the use of perioperative serum creatinine (sCr) for the identification of patients at risk for PO-AKI and long-term CKD. We also evaluated the incidence and risk factors associated with PO-AKI and renal function deterioration in patients undergoing major surgery for malignant disease. Methods Adult oncological patients who underwent major abdominal surgery from November 2016 to February 2017 were considered for this single-centre, observational retrospective study. Routinely available sCr values were used to define AKI in the first three postoperative days. Long-term kidney dysfunction (LT-KDys) was defined as a reduction in the estimated glomerular filtration rate by more than 10 ml/min/m2 at 12 months postoperatively. A questionnaire was administered to 125 physicians caring for the enrolled patients to collect information on local attitudes regarding the use of sCr perioperatively and its relationship with PO-AKI. Results A total of 423 patients were observed. sCr was not available in 59 patients (13.9%); the remaining 364 (86.1%) had at least one sCr value measured to allow for detection of postoperative kidney impairment. Among these, PO-AKI was diagnosed in 8.2% of cases. Of the 334 patients who had a sCr result available at 12-month follow-up, 56 (16.8%) developed LT-KDys. Data on long-term kidney function were not available for 21% of patients. Interestingly, 33 of 423 patients (7.8%) did not have a sCr result available in the immediate postoperative period or long term. All the physicians who participated in the survey (83 out of 125) recognised that postoperative assessment of sCr is required after major oncological abdominal surgery, particularly in those patients at high risk for PO-AKI and LT-KDys. Conclusion PO-AKI after major surgery for malignant disease is common, but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients. Trial registration ClinicalTrials.gov, NCT04341974.

Assessing the Predictive Power of Vulnerability Measures: Evidence from Panel Data for Argentina and Chile

2013 ◽  
Author(s):  
Marcelo Bérgolo ◽  
Guillermo Cruces ◽  
Andrés Ham
Keyword(s):  
Panel Data ◽  
Predictive Power ◽  
Household Level ◽  
Short And Long Term ◽  
Biased Estimates

This article carries out a validation exercise of vulnerability measures as predictors of poverty at the aggregate and micro levels based on short and long term panel data for Argentina and Chile. It then compares their performance to that of deprivation indicators. The main findings indicate that while vulnerability measures are good predictors of poverty in the aggregate, the same does not occur at household level. These results imply that while useful, vulnerability estimates require incorporating shocks to attenuate biased estimates if they are to be used for targeting purposes.

scholarly journals 204 * SHORT- AND LONG-TERM SURVIVAL ACCORDING TO THE EXTENT OF PULMONARY RESECTION IN GERIATRIC LUNG CANCER PATIENTS

2013 ◽  
Vol 17 (suppl 2) ◽  
pp. S118-S119
Author(s):  
Y. Hwang ◽  
J. H. Jeon ◽  
H. S. Kim ◽  
I. K. Park ◽  
C. H. Kang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Pulmonary Resection ◽  
Term Survival ◽  
Long Term Survival ◽  
Lung Cancer Patients ◽  
Short And Long Term

scholarly journals Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations

2015 ◽  
Vol 26 (2) ◽  
pp. 288-300 ◽  
Author(s):  
L. Decoster ◽  
K. Van Puyvelde ◽  
S. Mohile ◽  
U. Wedding ◽  
U. Basso ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Geriatric Assessment ◽  
Health Problems ◽  
Screening Tools ◽  
Older Cancer Patients ◽  
Multidimensional Health
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