Comprehensive geriatric assessment prediction of postoperative complications in gastrointestinal cancer patients: a meta-analysis

Dan-dan Xue,1,2 Yun Cheng,1 Mei Wu,2 Yan Zhang3 1Nursing Department, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China; 2School of Nursing, Fudan University, Shanghai, People’s Republic of China; 3Department of General Surgery, Huadong Hospita...

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Autores principales: Xue DD, Cheng Y, Wu M, Zhang Y
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Lenguaje:EN
Publicado: Dove Medical Press 2018
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spelling oai:doaj.org-article:e9cb713e4f1443889f25863ee37719852021-12-02T01:38:51ZComprehensive geriatric assessment prediction of postoperative complications in gastrointestinal cancer patients: a meta-analysis1178-1998https://doaj.org/article/e9cb713e4f1443889f25863ee37719852018-04-01T00:00:00Zhttps://www.dovepress.com/comprehensive-geriatric-assessment-prediction-of-postoperative-complic-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Dan-dan Xue,1,2 Yun Cheng,1 Mei Wu,2 Yan Zhang3 1Nursing Department, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China; 2School of Nursing, Fudan University, Shanghai, People’s Republic of China; 3Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China Background: Gastrointestinal cancer is an age-associated disease, and geriatric patients are mostly likely to suffer from postoperative complications. Some studies indicated that comprehensive geriatric assessment (CGA) could predict postoperative complications in gastrointestinal cancer patients. However, the evidence is mixed. Objective: This study aimed to conduct a meta-analysis to identify the effectiveness of CGA for predicting postoperative complications in gastrointestinal cancer patients. Methods: The Joanna Briggs Institute Library, Cochrane Library, PubMed, Embase, Web of Science, CINAHL Complete and four Chinese databases were searched for studies published up to March 2017. Two reviewers independently screened literature, extracted data and assessed the quality of included studies. RevMan5.3 was used for meta-analysis or only descriptive analysis. Results: Six studies were included, with 1,037 participants in total. In all, 13 components of CGA were identified, among which comorbidity (Charlson Comorbidity Index [CCI] ≥3; odds ratio [OR]=1.31, 95% CI [1.06, 1.63], P=0.01), polypharmacy (≥5 drugs/day; OR=1.30, 95% CI [1.04, 1.61], P=0.02) and activities of daily living (ADL) dependency (OR=1.69, 95% CI [1.20, 2.38], P=0.003) were proven relevant to the prediction of postoperative complications. No conclusive relationship was established between instrumental activities of daily living (IADL) dependency (OR=1.18, 95% CI [0.73, 1.91], P=0.51), Mini-Mental State Examination (MMSE; OR=1.13, 95% CI [0.91, 1.41], P=0.27), potential malnutrition (OR=1.07, 95% CI [0.87, 1.31], P=0.54), malnutrition (OR=1.26, 95% CI [0.80, 1.99], P=0.32), Geriatric Depression Scale (GDS; OR=1.18, 95% CI [0.90, 1.55], P=0.24) and postoperative complications. Conclusion: Comorbidity (CCI ≥3), polypharmacy (≥5 drugs/day) and ADL dependency were predictive factors for postoperative complications in gastrointestinal cancer patients; the results of other geriatric instruments were not conclusive, pointing to insufficient studies and requirement of more original investigations. Keywords: comprehensive geriatric assessment, gastrointestinal cancer, complication, meta-analysisXue DDCheng YWu MZhang YDove Medical Pressarticlecomprehensive geriatric assessmentgastrointestinal cancercomplicationmeta-analysisGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 723-736 (2018)
institution DOAJ
collection DOAJ
language EN
topic comprehensive geriatric assessment
gastrointestinal cancer
complication
meta-analysis
Geriatrics
RC952-954.6
spellingShingle comprehensive geriatric assessment
gastrointestinal cancer
complication
meta-analysis
Geriatrics
RC952-954.6
Xue DD
Cheng Y
Wu M
Zhang Y
Comprehensive geriatric assessment prediction of postoperative complications in gastrointestinal cancer patients: a meta-analysis
description Dan-dan Xue,1,2 Yun Cheng,1 Mei Wu,2 Yan Zhang3 1Nursing Department, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China; 2School of Nursing, Fudan University, Shanghai, People’s Republic of China; 3Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China Background: Gastrointestinal cancer is an age-associated disease, and geriatric patients are mostly likely to suffer from postoperative complications. Some studies indicated that comprehensive geriatric assessment (CGA) could predict postoperative complications in gastrointestinal cancer patients. However, the evidence is mixed. Objective: This study aimed to conduct a meta-analysis to identify the effectiveness of CGA for predicting postoperative complications in gastrointestinal cancer patients. Methods: The Joanna Briggs Institute Library, Cochrane Library, PubMed, Embase, Web of Science, CINAHL Complete and four Chinese databases were searched for studies published up to March 2017. Two reviewers independently screened literature, extracted data and assessed the quality of included studies. RevMan5.3 was used for meta-analysis or only descriptive analysis. Results: Six studies were included, with 1,037 participants in total. In all, 13 components of CGA were identified, among which comorbidity (Charlson Comorbidity Index [CCI] ≥3; odds ratio [OR]=1.31, 95% CI [1.06, 1.63], P=0.01), polypharmacy (≥5 drugs/day; OR=1.30, 95% CI [1.04, 1.61], P=0.02) and activities of daily living (ADL) dependency (OR=1.69, 95% CI [1.20, 2.38], P=0.003) were proven relevant to the prediction of postoperative complications. No conclusive relationship was established between instrumental activities of daily living (IADL) dependency (OR=1.18, 95% CI [0.73, 1.91], P=0.51), Mini-Mental State Examination (MMSE; OR=1.13, 95% CI [0.91, 1.41], P=0.27), potential malnutrition (OR=1.07, 95% CI [0.87, 1.31], P=0.54), malnutrition (OR=1.26, 95% CI [0.80, 1.99], P=0.32), Geriatric Depression Scale (GDS; OR=1.18, 95% CI [0.90, 1.55], P=0.24) and postoperative complications. Conclusion: Comorbidity (CCI ≥3), polypharmacy (≥5 drugs/day) and ADL dependency were predictive factors for postoperative complications in gastrointestinal cancer patients; the results of other geriatric instruments were not conclusive, pointing to insufficient studies and requirement of more original investigations. Keywords: comprehensive geriatric assessment, gastrointestinal cancer, complication, meta-analysis
format article
author Xue DD
Cheng Y
Wu M
Zhang Y
author_facet Xue DD
Cheng Y
Wu M
Zhang Y
author_sort Xue DD
title Comprehensive geriatric assessment prediction of postoperative complications in gastrointestinal cancer patients: a meta-analysis
title_short Comprehensive geriatric assessment prediction of postoperative complications in gastrointestinal cancer patients: a meta-analysis
title_full Comprehensive geriatric assessment prediction of postoperative complications in gastrointestinal cancer patients: a meta-analysis
title_fullStr Comprehensive geriatric assessment prediction of postoperative complications in gastrointestinal cancer patients: a meta-analysis
title_full_unstemmed Comprehensive geriatric assessment prediction of postoperative complications in gastrointestinal cancer patients: a meta-analysis
title_sort comprehensive geriatric assessment prediction of postoperative complications in gastrointestinal cancer patients: a meta-analysis
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/e9cb713e4f1443889f25863ee3771985
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