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. 2012 May;60(5):967-73.
doi: 10.1111/j.1532-5415.2012.03915.x. Epub 2012 Mar 16.

Functional status after colon cancer surgery in elderly nursing home residents

Emily Finlayson  1 , Shoujun Zhao, W John Boscardin, Brant E Fries, C Seth Landefeld, R Adams Dudley
Affiliations

Functional status after colon cancer surgery in elderly nursing home residents

Emily Finlayson et al. J Am Geriatr Soc. 2012 May.

Abstract

Objectives: To determine functional status and mortality rates after colon cancer surgery in older nursing home residents.

Design: Retrospective cohort study.

Setting: Nursing homes in the United States.

Participants: Six thousand eight hundred twenty-two nursing home residents aged 65 and older who underwent surgery for colon cancer in the United States between 1999 and 2005.

Measurements: Changes in functional status were assessed before and after surgery using the Minimum Data Set Activity of Daily Living (MDS-ADL) summary scale, a 28-point scale in which score increases as functional dependence increases. Regression techniques were used to identify patient characteristics associated with mortality and functional decline 1 year after surgery.

Results: On average, residents who underwent colectomy had a 3.9-point worsening in MDS-ADL score at 1 year. One year after surgery, rates of mortality and sustained functional decline were 53% and 24%, respectively. In multivariate analysis, older age (≥ 80 vs 65-69, adjusted relative risk (ARR) = 1.53, 95% confidence interval (CI) = 1.15-2.04, P < .001), readmission after surgical hospitalization (ARR = 1.15, 95% CI = 1.03-1.29, P = .02), surgical complications (ARR = 1.11, 95% CI = 1.02-1.21, P = .01), and functional decline before surgery (ARR = 1.21, 95% CI = 1.11-1.32, P < .001) were associated with functional decline at 1 year.

Conclusion: Mortality and sustained functional decline are common after colon cancer surgery in nursing home residents. Initiatives aimed at improving surgical outcomes are needed in this vulnerable population.

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Conflict of interest statement

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.

Figures

Figure 1
Figure 1
1-year mortality and functional trajectories before and after surgery: (a) all residents and (b) residents stratified by baseline MDS-ADL score.
Figure 2
Figure 2
Proportion of residents who experienced ADL decline, maintenance of ADL, and death.
See this image and copyright information in PMC

References

    1. O’Connell JB, Maggard MA, Ko CY. Cancer-directed surgery for localized disease: decreased use in the elderly. Ann Surg Oncol. 2004;11:951–2. - PubMed
    1. Fried TR, Bradley EH, Towle VR, et al. Understanding the treatment preferences of seriously ill patients. N Engl J Med. 2002;346:1061–6. - PubMed
    1. Van Cleave JH, Egleston BL, McCorkle R. Factors affecting recovery of functional status in older adults after cancer surgery. J Am Geriatr Soc. 2010;59:34–43. - PMC - PubMed
    1. Amemiya T, Oda K, Ando M, et al. Activities of daily living and quality of life after elective surgery for gastric and colorectal cancers. Ann Surg. 2007;246:222–8. - PMC - PubMed
    1. Lawrence VA, Hazuda HP, Cornell JE, et al. Functional independence after major abdominal surgery in the elderly. J Am Coll Surg. 2004;199:762–72. - PubMed

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