Thoracic surgery with geriatric assessment and collaboration can prepare frail older adults for lung cancer surgery
© 2022 Wiley Periodicals LLC..
BACKGROUND AND OBJECTIVES: We assessed frailty, measured by a comprehensive geriatric assessment-based frailty index (FI-CGA), and its association with postoperative outcomes among older thoracic surgical patients.
METHODS: Patients aged ≥65 years evaluated in the geriatric-thoracic clinic between June 2016 through May 2020 who underwent lung surgery were included. Frailty was defined as FI-CGA > 0.2, and "occult frailty", a level not often recognized by surgical teams, as 0.2 < FI-CGA < 0.4. A qualitative analysis of geriatric interventions was performed.
RESULTS: Seventy-three patients were included, of which 45 (62%) were nonfrail and 28 (38%) were frail. "Occult frailty" was present in 23/28 (82%). Sixty-one (84%) had lung malignancy. Geriatric interventions included delirium management, geriatric-specific pain and bowel regimens, and frailty optimization. More sublobar resections versus lobectomies (61% vs. 25%) were performed among frail patients. Frailty was not significantly associated with overall complications (odds ratio [OR]: 2.4; 95% confidence interval [CI]: 0.88-6.44; p = 0.087), major complications (OR: 2.33; 95% CI: 0.48-12.69; p = 0.293), discharge disposition (OR: 2.8; 95% CI: 0.71-11.95; p = 0.141), or longer hospital stay (1.3 more days; p = 0.18).
CONCLUSION: Frailty and "occult frailty" are prevalent in patients undergoing lung surgery. However, with integrated geriatric management, these patients can safely undergo surgery.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:126 |
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| Enthalten in: |
Journal of surgical oncology - 126(2022), 2 vom: 01. Aug., Seite 372-382 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cooper, Lisa [VerfasserIn] |
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| Links: |
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| Themen: |
Comprehensive geriatric assessment |
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| Anmerkungen: |
Date Completed 12.07.2022 Date Revised 02.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/jso.26866 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM338632131 |
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| 245 | 1 | 0 | |a Thoracic surgery with geriatric assessment and collaboration can prepare frail older adults for lung cancer surgery |
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| 500 | |a Date Completed 12.07.2022 | ||
| 500 | |a Date Revised 02.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 Wiley Periodicals LLC. | ||
| 520 | |a BACKGROUND AND OBJECTIVES: We assessed frailty, measured by a comprehensive geriatric assessment-based frailty index (FI-CGA), and its association with postoperative outcomes among older thoracic surgical patients | ||
| 520 | |a METHODS: Patients aged ≥65 years evaluated in the geriatric-thoracic clinic between June 2016 through May 2020 who underwent lung surgery were included. Frailty was defined as FI-CGA > 0.2, and "occult frailty", a level not often recognized by surgical teams, as 0.2 < FI-CGA < 0.4. A qualitative analysis of geriatric interventions was performed | ||
| 520 | |a RESULTS: Seventy-three patients were included, of which 45 (62%) were nonfrail and 28 (38%) were frail. "Occult frailty" was present in 23/28 (82%). Sixty-one (84%) had lung malignancy. Geriatric interventions included delirium management, geriatric-specific pain and bowel regimens, and frailty optimization. More sublobar resections versus lobectomies (61% vs. 25%) were performed among frail patients. Frailty was not significantly associated with overall complications (odds ratio [OR]: 2.4; 95% confidence interval [CI]: 0.88-6.44; p = 0.087), major complications (OR: 2.33; 95% CI: 0.48-12.69; p = 0.293), discharge disposition (OR: 2.8; 95% CI: 0.71-11.95; p = 0.141), or longer hospital stay (1.3 more days; p = 0.18) | ||
| 520 | |a CONCLUSION: Frailty and "occult frailty" are prevalent in patients undergoing lung surgery. However, with integrated geriatric management, these patients can safely undergo surgery | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a comprehensive geriatric assessment | |
| 650 | 4 | |a frailty | |
| 650 | 4 | |a lung cancer | |
| 650 | 4 | |a thoracic surgery | |
| 700 | 1 | |a Gong, Yusi |e verfasserin |4 aut | |
| 700 | 1 | |a Dezube, Aaron R |e verfasserin |4 aut | |
| 700 | 1 | |a Mazzola, Emanuele |e verfasserin |4 aut | |
| 700 | 1 | |a Deeb, Ashley L |e verfasserin |4 aut | |
| 700 | 1 | |a Dumontier, Clark |e verfasserin |4 aut | |
| 700 | 1 | |a Jaklitsch, Michael T |e verfasserin |4 aut | |
| 700 | 1 | |a Frain, Laura N |e verfasserin |4 aut | |
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