Key result
Frailty, defined by an MPI score > 0.33, was associated with a significantly higher rate of major postoperative complications compared to fit patients (52% vs 16%, p < 0.01).
Why the study?
The study was conducted to evaluate whether the Multidimensional Prognostic Index score is associated with postoperative outcomes and to develop a prognostic model for complication-risk prediction after colorectal cancer surgery.
Does the Multidimensional Prognostic Index (MPI) score predict major postoperative complications and mortality in elderly patients undergoing elective colorectal cancer surgery?
Cohort (n=104)
Yes
Does the Multidimensional Prognostic Index (MPI) score predict major postoperative complications and mortality in elderly patients undergoing elective colorectal cancer surgery?
Absolute Event Rate: 52% vs 16%
p-value: p=< .01
The MPI score is strongly associated with major postoperative complications and mortality in elderly patients undergoing colorectal cancer surgery, serving as a key component for individual risk prediction.
MPI score may aid risk stratification in elderly CRC surgery; leaves open need for model validation before clinical use.
BACKGROUND: This study aims (I) to evaluate whether the Multidimensional Prognostic Index (MPI) score is associated with postoperative outcomes and (II) to develop a prognostic model for individual complication-risk prediction following colorectal cancer (CRC) surgery. METHOD: This is a prospective multicentric cohort study. Consecutive ≥75-year-old candidates for elective CRC surgery were enrolled from October 2017 to August 2019. Patients underwent standardized preoperative geriatric assessment including the MPI. Patients with MPI score > 0.33 were classified as frail. Logistic regression models were employed to evaluate variables associated with major postoperative complications and mortality, using 10-fold cross-validated LASSO (least absolute shrinkage and selection operator) for model selection. RESULTS: In all, 104 patients were included, 34 (33%) had MPI score > 0.33. Major postoperative complications occurred in 52% of frail versus 16% of fit (MPI score ≤ 0.33) patients (p < .01). Both 30-day (9% vs. 0%; p = .033) and 90-day mortality (18% vs. 1%; p < .01) were higher among frail patients. In multivariate analysis, MPI score was associated with adverse outcomes. A final postoperative complication predictive model was created, including MPI score, gait-speed test, ASA (American Society of Anesthesiology) score, surgical approach, and stoma creation. CONCLUSION: MPI score is strongly associated with postoperative major complications in CRC elderly patients and it is a primary component of an individual prediction model.
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Pata et al. (2020) conducted a cohort in colorectal cancer (n=104). MPI score > 0.33 (frail) vs. MPI score ≤ 0.33 (fit) was evaluated on Major postoperative complications (p=< .01). Frailty, defined by an MPI score > 0.33, was associated with a significantly higher rate of major postoperative complications compared to fit patients (52% vs 16%, p < 0.01).
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