Geriatric assessment using the G8 to predict postoperative complications in patients undergoing major uro-oncologic surgery: Comparison with the Charlson Comorbidity Index

Dae Hyoung Park, Sanghyun Yoo, Minh Tung Do, Hyun Sik Yoon, Gyoohwan Jung, Jungyo Suh, Hyeong Dong Yuk, Ja Hyeon Ku, Cheol Kwak, Hyeon Hoe Kim, Chang Wook Jeong

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the ability of the G8 assessment to predict postoperative complications in older adults undergoing major uro-oncologic surgery in comparison with the Charlson Comorbidity Index (CCI). Materials and methods: The study included patients ≥65 years old who underwent major uro-oncologic surgery between December 2017 and December 2019 and were enrolled in the Seoul National University Prospectively Enrolled Registry for Genitourinary Cancer (SUPER-GUC). Odds ratio (OR) smoothing was used to visualize risk according to G8 scores. Chi-square tests were used to compare postoperative complication rates according to G8 score or CCI category. Results: A total of 657 patients undergoing radical prostatectomies (n = 372, 56.6%), partial/radical nephrectomies (n = 149, 22.7%), radical cystectomies (n = 76, 11.6%), and nephroureterectomies (n = 60, 9.1%) were included. Complication rates did not significantly differ between patients with CCI scores ≥1 and those with CCI scores of 0 (15.0% vs. 12.4%, p = 0.34). However, the complication rate was significantly higher in patients with G8 scores ≤14 than in those with G8 scores >14 (18.1% vs. 10.5%, p = 0.005). When the OR smoothing curve was used to divide patients into three groups based on G8 scores of <10, 10–14, and > 14, we observed significant differences in complication rates among the groups (37.5% vs. 16.9%. vs. 10.5%; p = 0.001). Conclusion: The G8 can aid in predicting postoperative complications in patients ≥65 years old. Comprehensive geriatric assessment is warranted in patients with G8 scores ≤14 prior to major uro-oncologic surgery. Older patients with G8 scores <10 should be counseled regarding the very high risk of surgery.

Original languageEnglish
Pages (from-to)426-431
Number of pages6
JournalJournal of Geriatric Oncology
Volume13
Issue number4
DOIs
StatePublished - May 2022
Externally publishedYes

Keywords

  • Charlson Comorbidity Index
  • Comprehensive geriatric assessment
  • G8
  • Geriatric oncology
  • Nephrectomy
  • Postoperative complications
  • Questionnaire
  • Radical cystectomy
  • Radical nephroureterectomy
  • Radical prostatectomy

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