Geriatric assessment as a predictor of postoperative complications in elderly patients with hepatocellular carcinoma

被引:34
作者
Kaibori, Masaki [1 ,2 ]
Ishizaki, Morihiko [1 ]
Matsui, Kosuke [1 ]
Iida, Hiroya [1 ]
Inoue, Kentaro [1 ]
Nagashima, Fumio [3 ]
Kon, Masanori [1 ]
机构
[1] Kansai Med Univ, Hirakata Hosp, Dept Surg, 2-5-1 Shinmachi, Hirakata, Osaka 5731191, Japan
[2] Kansai Med Univ, Next Generat Minimally Invas Surg, Hirakata, Osaka 5731191, Japan
[3] Kyorin Univ, Sch Med, Dept Med Oncol, Mitaka, Tokyo 1811611, Japan
关键词
Geriatric assessment; Elderly patients; Postoperative complications; Hepatectomy; Liver cancer; NUTRITIONAL ASSESSMENT MNA; CHRONIC LIVER-INJURY; HEPATIC RESECTION; RADIOFREQUENCY ABLATION; PREOPERATIVE ASSESSMENT; CANCER; MORBIDITY; MORTALITY; SURVIVAL; EXERCISE;
D O I
10.1007/s00423-016-1388-1
中图分类号
R61 [外科手术学];
学科分类号
摘要
Older patients are considered to have increased risk for complications after major surgery, but age alone is not a reliable predictor of postoperative complications. However, no universal screening test adequately predicts postoperative complications in older patients. This prospective study recorded pertinent baseline geriatric assessment variables to identify risk factors for postoperative complications in hepatocellular carcinoma (HCC) for patients aged a parts per thousand yen70 years who undergo hepatectomy. We retrospectively analyzed 71 consecutive patients a parts per thousand yen70 years of age. Patients had geriatric assessments of baseline and later cognition, nutritional and functional status, and burden of comorbidities, completed preoperatively and at 1, 3, and 6 months postoperatively. Postoperative morbidities were recorded. Postoperative morbidities developed in 18 patients (25 %). Univariate analysis identified serum albumin, operating time and blood loss, cirrhosis, geriatric 8 (G8), and Mini Nutritional Assessment as possible risk factors for postoperative complications, but only G8 < 14 survived multivariate analysis as an independent predictor of complications. Our findings indicate that the G8 score, based on patients' nutritional assessments, is a useful screening method for older HCC patients who qualify for elective liver resection. Preoperative G8 scores can help forecast postoperative complications in older HCC patients. Future studies with larger numbers of patients, limited to HCC and liver resections, are needed to verify our results.
引用
收藏
页码:205 / 214
页数:10
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