scholarly journals Risk scores to predict mortality 2 and 5 years after surgery for colorectal cancer in elderly patients

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Nerea González ◽  
Ane Loroño ◽  
Urko Aguirre ◽  
Santiago Lázaro ◽  
Marisa Baré ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Risk Scores ◽  
First Year ◽  
Residual Tumour ◽  
Colorectal Cancer Surgery ◽  
Predictors Of Mortality ◽  
Link Type ◽  
Observational Prospective Cohort Study

Abstract Background The aim of this study was to identify predictors of mortality in elderly patients undergoing colorectal cancer surgery and to develop a risk score. Methods This was an observational prospective cohort study. Individuals over 80 years diagnosed with colorectal cancer and treated surgically were recruited in 18 hospitals in the Spanish National Health Service, between June 2010 and December 2012, and were followed up 1, 2, 3, and 5 years after surgery. Sociodemographic and clinical data were collected. The primary outcomes were mortality at 2 and between 2 and 5 years after the index admission. Results The predictors of mortality 2 years after surgery were haemoglobin ≤ 10 g/dl and colon locations (HR 1.02; CI 0.51–2.02), ASA class of IV (HR 3.55; CI 1.91–6.58), residual tumour classification of R2 (HR 7.82; CI 3.11–19.62), TNM stage of III (HR 2.14; CI 1.23–3.72) or IV (HR 3.21; CI 1.47–7), LODDS of more than − 0.53 (HR 3.08; CI 1.62–5.86)) and complications during admission (HR 1.73; CI 1.07–2.80). Between 2 and 5 years of follow-up, the predictors were no tests performed within the first year of follow-up (HR 2.58; CI 1.21–5.46), any complication due to the treatment within the 2 years of follow-up (HR 2.47; CI 1.27–4.81), being between 85 and 89 and not having radiotherapy within the second year of follow-up (HR 1.60; CI 1.01–2.55), no colostomy closure within the 2 years of follow-up (HR 4.93; CI 1.48–16.41), medical complications (HR 1.61; CI 1.06–2.44), tumour recurrence within the 2 years of follow-up period (HR 3.19; CI 1.96–5.18), and readmissions at 1 or 2 years of follow-up after surgery (HR 1.44; CI 0.86–2.41). Conclusion We have identified variables that, in our sample, predict mortality 2 and between 2 and 5 years after surgery for colorectal cancer older patients. We have also created risks scores, which could support the decision-making process. Trial registration ClinicalTrials.gov, NCT02488161.

scholarly journals Post-operative outcomes and predictors of mortality after colorectal cancer surgery in the very elderly patients

Heliyon ◽  
2019 ◽  
Vol 5 (8) ◽  
pp. e02363
Author(s):  
Matteo Novello ◽  
Francesco Vito Mandarino ◽  
Salomone Di Saverio ◽  
Davide Gori ◽  
Marialuisa Lugaresi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Cancer Surgery ◽  
Very Elderly ◽  
Colorectal Cancer Surgery ◽  
Predictors Of Mortality ◽  
Operative Outcomes

scholarly journals Experiences of recovery from colorectal cancer surgery after hospital discharge among the oldest old: A qualitative study

2021 ◽  
pp. 205715852199445
Author(s):  
Kristina Sundt Eriksen ◽  
Sissel Iren Eikeland Husebø ◽  
Hartwig Kørner ◽  
Kirsten Lode
Keyword(s):  
Colorectal Cancer ◽  
Thematic Analysis ◽  
Oldest Old ◽  
Healthcare Services ◽  
Hospital Data ◽  
Colorectal Cancer Surgery ◽  
Discharge From Hospital ◽  
Depth Interviews ◽  
Inductive Thematic Analysis

Colorectal cancer affects a large number of people aged ≥80 years. Little is known about how they manage after discharge from hospital. The aim of this study was to explore the experiences of individuals aged ≥80 years recovering from surgery for colorectal cancer, and the challenges they may encounter after discharge from hospital. Data were collected between January and March 2016 through in-depth interviews with ten participants approximately one month after surgery. Inductive thematic analysis was employed to analyse the data. The COREQ checklist was used in reporting this study. Two themes were identified: Managing the recovery from CRC surgery, and Insufficient follow-up from the healthcare services after CRC surgery. The findings indicate that older people treated for colorectal cancer manage surprisingly well after discharge despite challenges in their recovery; however, there are seemingly areas of improvement in their follow-up healthcare.

P1560Prognostic predictors of mortality in very elderly patients presenting with NSTEMI

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Cacho ◽  
A Cordero Fort ◽  
T Gonzalez Ferrero ◽  
M Perez Dominguez ◽  
A Torrelles Fortuny ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Elderly Patients ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Beta Blockers ◽  
Coronary Revascularization ◽  
Very Elderly ◽  
Younger Patients ◽  
Predictors Of Mortality

Abstract Background Elderly patients are usually under-represented in randomized controlled trials, therefore there is less data providing prognostic information for this particular group. NSTEMI clinical practice guidelines indicate that older patients should receive the same therapeutic strategy than younger patients. Methods Observational retrospective study including 8771 patients admitted for acute coronary syndrome in two tertiary referral hospitals between 2003 and 2017: 5673 NSTEMI (64.3%) and 3098 STEMI (35.7%). 999 patients presenting with NSTEMI and aged over 75 years were selected and divided into 3 groups: aged 75–80, aged 80–89 and aged over 90. Cox proportional hazard regression analysis was performed in order to determine independent predictors of mortality. Mortality and survival were represented by Kaplan-Meier curves and log rank test was conducted to assess significant differences in survival between groups. Median follow-up period was 48 months. Results A significant association between female sex and elder age was observed, also a higher prevalence of hyperlipemia and diabetes. In acute phase, no significant differences were found in between congestive heart failure onset, myocardial re-infarction, acute renal failure, stroke or in-hospital mortality amongst the 3 groups. However, at follow-up period, higher mortality in elder groups was documented. After performing a multivariate analysis, age was identified as an independent predictor of mortality at follow-up (<90 years: HR 1.50 CI 95% 1.23–1.83, p=0.0001, >90 years: HR 1.93 CI 95% 1.27–2.93, p=0.002) as well as GRACE score (HR 1.06, CI 95% 1.02–1.09, p=0.002), CRUSADE score (HR 1.01 CI 95% 1.01–1.02, p=0.0001) and treatment with digoxine (HR 1.38 CI 95% 0.95–2.0, p=0.08). On the other side, beta-blockers (HR 0.71 CI 95% 0.59–0.86, p=0.0001) and complete coronary revascularization (HR 0.48 CI 95% 0.37–0.64, p=0.0001) were found to be protective factors. Conclusions In very elderly patients presenting with NSTEMI, prognostic predictors of mild-term mortality are similar to those present in younger patients. Recommendations of clinical practice guidelines, such as beta-blockers' treatment and coronary revascularization, should also be applied in elderly patients.

Life is back to normal and yet not - partners’ and patient’s experiences of life of the first year after colorectal cancer surgery

2011 ◽  
Vol 21 (3-4) ◽  
pp. 555-563 ◽  
Author(s):  
Emma Ohlsson-Nevo ◽  
Birgitta Andershed ◽  
Ulrica Nilsson ◽  
Agneta Anderzén-Carlsson
Keyword(s):  
Colorectal Cancer ◽  
Cancer Surgery ◽  
First Year ◽  
Colorectal Cancer Surgery

Characteristics and results of treatment of patients treated surgically with colorectal cancer in old and senile age

2018 ◽  
Vol 90 (1) ◽  
pp. 1-6
Author(s):  
Zbigniew Banaszkiewicz ◽  
Tomasz Zwoliński ◽  
Krzysztof Tojek ◽  
Paweł Jarmocik ◽  
Arkadiusz Jawień
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Overall Survival ◽  
Old Age ◽  
Colonic Cancer ◽  
First Year ◽  
Overall Survival Rate ◽  
Younger Patients ◽  
Results Of Treatment

Colorectal cancer (CC) in Poland is the type of cancer with the highest dynamics of disease growth and is epidemiologically related to age. The analysis involved 353 patients operated on due to CC in senile and old age and compared with younger patients. It was found that people at this age are more often diagnosed with CC They were more often women, the patients did not differ in the stage of cancer, while they were significantly more often qualified for surgery due to urgent indications. In patients with colonic cancer, the resectability and radicality of the procedures in comparison with patients with rectal cancer was significantly higher, while there were more complications and deaths in the 30-day follow-up in this group. The overall survival in senile and old age was significantly worse. In the first year of follow-up after surgical treatment of patients in this group, complications and deaths were more frequently observed. However, in patients who survived 12 months after the operation, the overall survival rate did not significantly differ.

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