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April 17, 2014Annals of Surgery41 citations

Postoperative Transitional Care Needs in the Elderly

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LLLinda T. LiGBG.M. BardenCBCourtney J. Balentine

Key Result

Age 75 years or older was associated with a significantly increased risk of requiring transitional care needs after colorectal cancer surgery (OR 4.7; 95% CI 2.6-8.5).

Study Design

Type

Cohort (n=486)

Multicenter

No

Structured PICO

P
Population
486 patients undergoing curative surgery for colorectal cancer at a single tertiary referral center between 2002 and 2011.
O
Outcome
Transitional care needs (TCNs) (home health or nonhome destination at discharge) and overall survival (OS)hard clinical

Transitional care needs after colorectal cancer surgery are common, especially in patients 75 years or older, and are associated with worse long-term survival.

Main Result

Odds Ratio: 4.7 (95% CI 2.6–8.5)

p-value: p=<0.01

Abstract

In Brief Objective: To characterize transitional care needs (TCNs) after colorectal cancer (CRC) surgery and examine their association with age and impact on overall survival (OS). Background: TCNs after cancer surgery represent additional burden for patients and are associated with higher short-term mortality. They are not well-characterized in CRC patients, particularly in the context of a growing elderly population, and their effect on long-term survival is unknown. Methods: A retrospective cohort study of CRC patients (N = 486) having curative surgery at a tertiary referral center (2002–2011) was conducted. Outcomes included TCNs (home health or nonhome destination at discharge) and OS. Patients were compared on the basis of age: young (<65 years), old (65–74 years), and oldest (≥75 years). Multivariate logistic regression models were used to examine the association of age with TCNs, and OS was compared on the basis of TCNs and stage, using the Kaplan-Meier method. Results: TCNs were required by 130 patients (27%). The oldest patients had highest TCNs (49%) compared with the other age groups (P < 0.01), with rehabilitation services as their primary TCNs (80%). After multivariate analysis, patients 75 years or older had significantly increased TCN risk (odds ratio, 4.7; 95% confidence interval, 2.6–8.5). TCN was associated with worse OS for patients with early- and advanced stage CRC (P < 0.001). Conclusions: TCNs after CRC surgery are common and significantly increased in patients 75 years or older, represent an outcome of postoperative recovery, and are associated with worse long-term survival. Preoperative identification of higher risk populations should be used for patient counseling, advanced preoperative planning, and to implement strategies targeted at minimizing TCNs. Postoperative transitional care needs (TCNs) after colorectal cancer (CRC) surgery are unknown. We sought to evaluate TCNs after CRC surgery and examine their association with age and effect on long-term survival. TCNs after CRC surgery are particularly common in elderly patients (≥75 years), representing an outcome of recovery and a risk factor for worse overall survival.

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Cite This Study

Li et al. (2014) conducted a cohort in Colorectal cancer (n=486). Age ≥75 years vs. Age <75 years was evaluated on Transitional care needs (TCNs) (OR 4.7, 95% CI 2.6-8.5, p=<0.01). Age 75 years or older was associated with a significantly increased risk of requiring transitional care needs after colorectal cancer surgery (OR 4.7; 95% CI 2.6-8.5).

synapsesocial.com/papers/6a9c615e3a49b5247f76dcadhttps://doi.org/10.1097/sla.0000000000000673
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