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Cooper, Lisa; Gong, Yusi; Dezube, Aaron R.; Mazzola, Emanuele; Deeb, Ashley L.; Dumontier, Clark; Jaklitsch, Michael T.; Frain, Laura N.

Thoracic surgery with geriatric assessment and collaboration can prepare frail older adults for lung cancer surgery

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  • Medientyp: E-Artikel
  • Titel: Thoracic surgery with geriatric assessment and collaboration can prepare frail older adults for lung cancer surgery
  • Beteiligte: Cooper, Lisa; Gong, Yusi; Dezube, Aaron R.; Mazzola, Emanuele; Deeb, Ashley L.; Dumontier, Clark; Jaklitsch, Michael T.; Frain, Laura N.
  • Erschienen: Wiley, 2022
  • Erschienen in: Journal of Surgical Oncology, 126 (2022) 2, Seite 372-382
  • Sprache: Englisch
  • DOI: 10.1002/jso.26866
  • ISSN: 0022-4790; 1096-9098
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: AbstractBackground and ObjectivesWe assessed frailty, measured by a comprehensive geriatric assessment‐based frailty index (FI‐CGA), and its association with postoperative outcomes among older thoracic surgical patients.MethodsPatients 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.ResultsSeventy‐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).ConclusionFrailty and “occult frailty” are prevalent in patients undergoing lung surgery. However, with integrated geriatric management, these patients can safely undergo surgery.