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  • Meeting abstract
  • Open Access

Preoperative risk estimation for onco-geriatric patients (PREOP) – preoperative assessment of elderly surgical patients

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BMC Geriatrics20099 (Suppl 1) :A94

https://doi.org/10.1186/1471-2318-9-S1-A94

  • Published:

Keywords

  • Preoperative Assessment
  • Preoperative Risk
  • Frail Individual
  • Brief Fatigue Inventory
  • Vulnerable Elder

Background

Most cancer patients undergoing surgery are aged ≥ 70, with 1/3 considered frail and at poor surgical risk.

Preoperative assessment of oncogeriatric patients may expand survival and improve quality of life.

Preoperative Assessment of Cancer in the Elderly (PACE) was useful in identifying those individuals with a poor surgical risk. Instrumental Activities of Daily Living (IADL), Brief Fatigue Inventory (BFI) and Performance Status (PS) correlate with operative 30-day mortality, while Activities of Daily Living (ADL), IADL and PS associate with a lengthy post-operative hospital stay.

PACE administration (Table 1) allows personalized oncological management but it's time-consuming (30 mins/pt). Newly developed screening tools might be as effective, but were never tested in a surgical scenario.
Table 1

Tools used in PREOP study vs. PACE study

 

Tool

Abbreviation

PREOP

Groningen Frailty Index

GFI

 

Vulnerable Elders Survey

VES-13

 

"Up and go test"

Up and go

PACE

Mini-Mental State

MMS

 

Modified index of comorbidities

Satariano

 

Activities of Daily Living

ADL

 

Instrumental Activities of Daily Living

IADL

 

Geriatric Depression Scale

GDS

 

Brief Fatigue Inventory

BFI

 

Eastern Cooperative Oncology Group performance status

PS

 

American Society of Anaesthesiologists

ASA

 

Physiological and Operative Severity Score for enumeration of Mortality and Morbidity

POSSUM

 

Portsmouth POSSUM modification

P-POSSUM

Groningen Frailty Index (GFI), Vulnerable Elders Survey (VES-13) and the "up and go test" (Table 1) are quick tools, capable of identifying frail individuals.

PREOP is an international prospective investigation aiming to analyzing the predictive value of these new tools which are due to be compared against PACE.

Materials and methods

A prospective series of patients aged ≥ 70 years, undergoing elective cancer surgery will be recruited.

PACE, GFI, VES-13 and "up and go" will be pre-operatively administered. Pre-, peri- and post-operative data will be collected and entered into the database. 326 patients will need to be recruited within 2 years to allow analysis.

Authors’ Affiliations

(1)
Department of General and Emergency Surgery, S. Maria Hospital, Terni-University of Perugia, Italy
(2)
St Helens Hospital, University of Liverpool, Liverpool, UK

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