Evaluation of geriatric assessment for head and neck cancer surgery

W. Okano, K. Matsuura, R. Hayashi, Masashi Wakabayashi, Yohei Morishita, Toshifumi Tomioka, T. Shinozaki
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Abstract

Background: In the treatment of cancer in the elderly, we experience cases in which the outcomes cannot be followed as planned even if wound healing is good. In recent years, it has been globally recommended to carry out a geriatric assessment (GA) to identify risks in advance and perform necessary interventions. Materials and methods: GA was performed from August 2019 to March 2020 for 105 patients aged 65 and over who were scheduled for surgery in our department. We conducted a retrospective study to investigate the relationship between GA and postoperative outcomes, such as complications, delirium, and non-home discharge. Results: Non-home discharge was positive for IADL in all cases and was associated with MOS and reconstructive surgery (p=0.01, 0.01). All cases had gastrostomy or tracheal stoma. Reconstructive surgery tended to be associated with both complications and delirium (p=0.08, 0.05). Consideration: Non-home discharge is considered to be highly probable in case of postoperative gastric fistula or tracheal stoma, IADL positive, and MOS positive or reconstructive surgery. Conclusions: GA was performed on elderly patients scheduled for surgery in our department, and a relationship between non-home discharge and GA tools was found.
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头颈癌手术的老年评估
背景:在老年人癌症的治疗中,我们遇到过即使伤口愈合良好,结果也不能按计划进行的病例。近年来,全球都建议开展老年评估(GA),以提前识别风险并实施必要的干预措施。材料与方法:对2019年8月至2020年3月在我科计划手术的65岁及以上患者105例进行GA。我们进行了一项回顾性研究,以调查GA与术后预后(如并发症、谵妄和非家庭出院)之间的关系。结果:所有病例非家庭出院时IADL均阳性,且与MOS和重建手术相关(p=0.01, 0.01)。所有病例均行胃造口或气管造口术。重建手术往往与并发症和谵妄相关(p=0.08, 0.05)。考虑:术后胃瘘或气管瘘,IADL阳性,MOS阳性或重建手术,是非家庭出院的可能性很大。结论:我科对计划手术的老年患者进行了GA,并发现了非家庭出院与GA工具之间的关系。
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来源期刊
Japanese Journal of Head and Neck Cancer
Japanese Journal of Head and Neck Cancer Medicine-Otorhinolaryngology
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