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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 5/2015

01-05-2015 | Original Article

Pre-surgical Geriatric Syndromes, Frailty, and Risks for Postoperative Delirium in Older Patients Undergoing Gastrointestinal Surgery: Prevalence and Red Flags

Authors: Cheryl Chia-Hui Chen, Ming-Tsan Lin, Jin-Tung Liang, Chun-Min Chen, Chung-Jen Yen, Guan-Hua Huang

Published in: Journal of Gastrointestinal Surgery | Issue 5/2015

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Abstract

Objective

We sought to identify and evaluate red flags for pre-surgical geriatric conditions (geriatric syndromes, frailty, and risks for postoperative delirium) in older patients undergoing gastrointestinal surgery.

Methods

Older individuals (≥65 years) undergoing major elective gastrointestinal surgery from 2009 to 2012 were enrolled and assessed preoperatively.

Results

Participants (N = 379; mean age = 74.5 ± 5.9 years) primarily underwent colorectal (54.3 %), gastric (21.9 %), and pancreatobiliary (12.6 %) surgery. Overall, 30.9 % had existing geriatric syndromes, 26.7 % were frail, and 22.8 % had >3 risk factors for postoperative delirium. The largest proportion (45.7 %) presented with at least one geriatric condition. Patients with or without geriatric conditions were discriminated with adequate sensitivity (67 %), specificity (84 %), and positive predictive value (77 %) by eight red flags: age ≥75 years (OR, 2.86; P < 0.001), eating soft food (OR, 3.63; P = 0.001), reported hypertension (OR, 2.8; P = 0.001), weight loss >3 kg (OR, 4.79; P < 0.001), fair-to-weak grip strength (OR, 2.53; P = 0.001), sleeplessness (OR, 2.57; P = 0.001), no-better-than-peer perceived health (OR, 1.88; P = 0.022), and short-term inability to recall two of three common words (OR, 1.81; P = 0.025).

Conclusions

Eight red flags covered as part of history and physical examination are well suited to screen patients for geriatric conditions indicating the need for preoperative geriatric assessments and optimization.
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Metadata
Title
Pre-surgical Geriatric Syndromes, Frailty, and Risks for Postoperative Delirium in Older Patients Undergoing Gastrointestinal Surgery: Prevalence and Red Flags
Authors
Cheryl Chia-Hui Chen
Ming-Tsan Lin
Jin-Tung Liang
Chun-Min Chen
Chung-Jen Yen
Guan-Hua Huang
Publication date
01-05-2015
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 5/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-015-2760-0

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