Older individuals are often at increased risk for complications following a surgical procedure. Now, a new UCLA study has found that seniors who undergo cancer surgery are more likely than their younger counterparts to experience injuries and health issues such as falling down, breaking bones, dehydration, bed sores, failure to thrive and delirium. As a result, hospital stays are longer, healthcare costs are higher, and the risk of desk is greater. The findings appear on February 16 in the Journal of Clinical Oncology.
The study authors note that these problems can occur in addition to postoperative complications, making them much more challenging to handle and more difficult for the patients to recover from. They also found that these complications are particularly common among individuals who undergo major abdominal surgery for cancer.
The 18-month study presents issues related to frailty and reduced functionality, which are conditions of the elderly that tend to be eclipsed by more common objects of study, such as survival rates and chemotherapy toxicity. The findings could lead to better care planning and, the researchers hope, better outcomes for patients whose age puts them at higher risk, noted first author Hung-Jui Tan, MD, a fellow in urologic oncology at UCLA. He explained, “The findings highlight the importance for older patients to discuss these potential events with their doctors as they prepare for surgery. Now that the prevalence of such events is known, treatment approaches that keep these age-related health concerns in mind may be better applied in the future to better assist these patients.”
Dr. Tan notes that as the American population gets older, this distinctive set of health issues will only become more common and more urgent to address. He explained, “Even now, these events affect approximately one in 10 patients over the age of 54 undergoing cancer surgery in the United States. With even higher rates observed among the very old, patients 75 and older, the fastest-growing segment of the population, geriatric events during cancer-related surgery are likely to become even more prevalent.”
For the study, the investigators reviewed nationwide data on hospital admissions for major cancer surgery in individuals aged 65 and older; they also studied a younger group of individuals, aged 55 to 64. Both groups of patients underwent surgery from 2009 through 2011. The researchers searched for specific age-related events and estimated their prevalence in relation to age, other health problems and the location of the cancer. Within the total sample of 939,150 patients, the investigators identified at least one age-related event in 9.2% of cases, with much higher rates in patients 75 and older and those undergoing surgery for bladder, ovarian, colorectal, pancreatic, or stomach cancer. They also found that those patients experiencing age-related health issues had a greater risk of simultaneous complications and of being discharged to rehabilitation facilities rather than their own homes.
The researchers next plan to further assess the relationship between geriatric events and other outcomes; for example, they will examine the causal direction between age-related events and complications from surgery. They will also work to develop proactive ways to address these health concerns for patients who need cancer surgery. The authors wrote: “These events may add to operative morbidity and resource utilization, straining both patients and the cancer care delivery system. Efforts aimed at addressing older age-related health concerns and reducing associated morbidity will be essential as the number of older adults with cancer continues to grow.”