Comparison of common risk stratification indices to predict outcomes among stage IV cancer patients with bowel obstruction undergoing surgery

Abstract

ASA, CCI, and mFI are limited in their ability to predict postoperative adverse events among DMa patients undergoing surgery for bowel obstruction. These data suggest that a more tailored preoperative risk stratification tool would improve treatment planning.

The Frequency of, and Factors Associated with Prolonged Hospitalization: A Multicentre Study in Victoria, Australia

“…Most previous studies of prolonged hospitalization have focused on specific sub-groups of patients such as orthopaedic procedures [ 21 , 24 , 26 , 29 , 30 , 31 , 39 ], cardiovascular disease [ 13 , 15 , 17 , 36 , 37 , 38 ], solid organ transplantation [ 33 , 50 ], or oncological conditions [ 11 , 14 , 18 , 20 , 27 , 28 , 34 , 35 ] ( Supplementary Table S7 ). A limited number of studies have examined the epidemiology of prolonged hospitalization in internal medicine patients [ 23 , 45 , 51 ] but only one of these was multi-centre in nature [ 51 ].…”

“…Importantly, this cutoff was chosen a priori. Other studies have variably defined prolonged hospitalization as admissions lasting more than seven days [ 19 , 23 , 29 , 37 , 38 ] or above the 75th centile for length of stay [ 11 , 12 , 14 , 15 , 17 , 20 , 26 , 27 , 30 , 40 ].…”

“…Several studies have identified factors associated with protracted hospitalization, but many of these have focused on targeted patient populations [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ] or involved data collected at a single centre [ 13 , 18 , 19 , 23 , 24 , 28 , 29 , 31 , 37 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ] Understanding the factors that contribute to prolonged hospitalization in a broader patient cohort may guide the development of interventions that target at risk patients, improve overall care, and reduce resource utilisation.…”

Does frailty predict postoperative outcomes in geriatric patients receiving surgery for colorectal cancer? A systematic review and meta-analysis

“…Second, frailty is frequently accompanied by the coexistence of multi-morbidity, being more frequent with increasing degrees of frailty [33]. However, while preoperative comorbidities and ASA classi cation are widely accepted as perioperative risk strati cation tools and associated with higher risks of complications and mortality [34], the predictive value of frailty assessment instruments in conjunction with co-morbidity or perioperative complications on mortality is still limited in literature [35].…”

The Role of Palliative Surgery for Malignant Bowel Obstruction and Perforation in Advanced Microsatellite Instability-High Colorectal Carcinoma in the Era of Immunotherapy: Case Report

“…Our previous work analyzing a large statewide database indicated that compared to medical management, surgical management of malignant bowel obstructions was associated with increased complications, increased in-hospital mortality, and lower rates of discharges to home (2). This is made more difficult by the finding that common risk stratification tools (American Society of Anesthesiology classification, Charlson comorbidity index, and modified frailty score), do not adequately predict postoperative adverse events in this population (3). These considerations are especially challenging for patients receiving chemotherapy, as both invasive surgery and chemotherapy require fit patients with good performance status to optimize the risk/benefit ratio of multimodality therapy.…”