Prehabilitation and perioperative geriatric care in patients aged over 80 years with colorectal cancer: Results of a cross-speciality geriatrics program

Objectives: To describe a perioperative cross-speciality geriatrics program for patients aged >80 years with colo-rectal cancer (CRC), aimed to detect and manage frailty and to understand its influence on clinical outcomes.Materials and methods: Patients aged >80 years with CRC and proposed for surgery were included from October 2018 to March 2020. Comprehensive geriatric assessments (CGA) were performed. Patients were classified ac-cording to the estimated physiological reserve, from fit, frail patients and even the disabled: CGA-1, CGA-2, CGA-3, and CGA-4. Individualised treatment was adapted to each patient's situation. Patients who underwent surgery were followed up by a geriatrician. The presence of complications, length of stay, hospital readmissions at 30 days, and short-and long-term mortality were recorded.Results: Seventy-four patients were included. The mean age was 84.5 +/- 4.5 years. 55.4% patients were classified as CGA-1, 24.3% as CGA-2, 16.2% as CGA-3, and 4.1% as CGA-4. No CGA-4 patient was operated on. Frail (CGA-2 and CGA-3) patients had higher medical complications (50% vs 21.2%, p < 0.05) and delirium (30% vs 9.1%, p < 0.05) than fit patients (CGA-1). They also had higher rates of surgical complications (20% vs 15.2%), longer hos-pital stay (10 +/- 6.2 vs 8.4 +/- 4.2 days), 30-day readmissions (15% vs 6.3%), and mortality at six (10% vs 3%) and twelve months (20% vs 6.1%), although it was not statistically significant.Conclusion: CGA and prehabilitation can classify patients according to their frailty status, support clinicians in decision-making to achieve tailored treatment, and detect clinical conditions for intervention in multiple do-mains of health in the perioperative period. (c) 2022 Elsevier Ltd. All rights reserved.