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

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Abstract

Background

Comprehensive geriatric assessment (CGA) has become a predictor for elderly cancer patients in post-surgical complications, including post-discharge institutionalization and mortality.

Aims

To determine whether pre-operative medication use is associated with post-operative morbidity and mortality in oncology patients receiving CGA.

Methods

Patients aged 65 years 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 30 days after surgery and post-discharge institutionalization.

Results

A total of 475 cancer patients were included. Among them, three patients died within 30 days after surgery and 14 patients were discharged to another institution. All patients who died within 30 days 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%.

Conclusions

It 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.

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Authors and Affiliations

  1. Department of Pharmacy, Seoul National University Bundang Hospital, Seongnam, 13620, South Korea

    Kyung Suk Choi, Young Mi Jeong & Eunsook Lee

  2. College of Pharmacy and Division of Life Pharmaceutical Sciences, Ewha Womans University, 52 Ewhayeodae-gil Seodaemun-gu, Seoul, 03760, South Korea

    Kyung Suk Choi, Young Mi Jeong, Jeong Yee, Byung Koo Lee, Sandy Jeong Rhie & Hye Sun Gwak

  3. Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, 13620, South Korea

    Kwang Ill Kim

  4. Department of Pharmacy, Hanyang University, Ansan-si, 155588, South Korea

    Jee Eun Chung

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  1. Kyung Suk Choi
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  2. Young Mi Jeong
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  4. Kwang Ill Kim
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Corresponding authors

Correspondence to Sandy Jeong Rhie or Hye Sun Gwak.

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The authors have no conflicts of interest to disclose.

Ethical approval

All procedures performed in this study which involved human participants were in accordance with the ethical standards of Seoul National University Bundang Hospital Institutional Review Board (IRB No.: B-1705/396-107) and with Helsinki declaration.

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Written informed consent was obtained from all participants.

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Choi, K.S., Jeong, Y.M., Lee, E. et al. Association of pre-operative medication use with post-surgery mortality and morbidity in oncology patients receiving comprehensive geriatric assessment. Aging Clin Exp Res 30, 1177–1185 (2018). https://doi.org/10.1007/s40520-018-0904-2

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  • DOI: https://doi.org/10.1007/s40520-018-0904-2

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