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Association of pre-operative medication use with post-surgery mortality and morbidity in oncology patients receiving comprehensive geriatric assessment

Title
Association of pre-operative medication use with post-surgery mortality and morbidity in oncology patients receiving comprehensive geriatric assessment
Authors
Choi, Kyung SukJeong, Young MiLee, EunsookKim, Kwang IllYee, JeongLee, Byung KooChung, Jee EunRhie, Sandy JeongGwak, Hye Sun
Ewha Authors
곽혜선이병구이정연
SCOPUS Author ID
곽혜선scopus; 이병구scopusscopus; 이정연scopus
Issue Date
2018
Journal Title
AGING CLINICAL AND EXPERIMENTAL RESEARCH
ISSN
1594-0667JCR Link

1720-8319JCR Link
Citation
AGING CLINICAL AND EXPERIMENTAL RESEARCH vol. 30, no. 10, pp. 1177 - 1185
Keywords
Comprehensive geriatric assessmentDeath within 30daysPost-discharge institutionalizationPre-operative medicationSurgical oncology patients
Publisher
SPRINGER
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
BackgroundComprehensive geriatric assessment (CGA) has become a predictor for elderly cancer patients in post-surgical complications, including post-discharge institutionalization and mortality.AimsTo determine whether pre-operative medication use is associated with post-operative morbidity and mortality in oncology patients receiving CGA.MethodsPatients aged 65years or older who were scheduled for cancer surgery and presented for CGA were included in the present study. Baseline characteristics of patients were collected from electrical medical records, and pre-operative medication review was performed. The primary outcome was death within 30days after surgery and post-discharge institutionalization.ResultsA total of 475 cancer patients were included. Among them, three patients died within 30days after surgery and 14 patients were discharged to another institution. All patients who died within 30days after surgery had polypharmacy with marginal significance (P=0.087). Multivariate analysis models were constructed using significant factors for post-surgery institutionalization from univariate analysis: Model I (polypharmacy and transfusion), Model II (polypharmacy and infection), and Model III (polypharmacy, transfusion, and infection). Infection was the most significant factor. Its adjusted odds ratio was as large as 11.1 and attributable risk was almost 91%. In pre-surgery medication use, only polypharmacy showed significant association with post-discharge institutionalization. Attributable risk of polypharmacy was around 75%.ConclusionsIt is possible that pre-operative medication use has impact on death and post-discharge institutionalization in geriatric oncology patients, further highlighting the importance of medication optimization for elderly patients with cancer surgery.
DOI
10.1007/s40520-018-0904-2
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약학대학 > 약학과 > Journal papers
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