Geriatric assessment using the G8 to predict postoperative complications in patients undergoing major uro-oncologic surgery: Comparison with the Charlson Comorbidity Index

Abstract

Objective: To evaluate the ability of the G8 assessment to predict postoperative complications in older adults un-dergoing major uro-oncologic surgery in comparison with the Charlson Comorbidity Index (CCI).Materials and methods: The study included patients >= 65 years old who underwent major uro-oncologic surgery between December 2017 and December 2019 and were enrolled in the Seoul National University Prospectively Enrolled Registry for Genitourinary Cancer (SUPER-GUC). Odds ratio (OR) smoothing was used to visualize risk according to G8 scores. Chi-square tests were used to compare postoperative complication rates according to G8 score or CCI category.Results: A total of 657 patients undergoing radical prostatectomies (n = 372, 56.6%), partial/radical nephrecto-mies (n = 149, 22.7%), radical cystectomies (n = 76, 11.6%), and nephroureterectomies (n = 60, 9.1%) were in-cluded. Complication rates did not significantly differ between patients with CCI scores >= 1 and those with CCI scores of 0 (15.0% vs. 12.4%, p = 0.34). However, the complication rate was significantly higher in patients with G8 scores <= 14 than in those with G8 scores >14 (18.1% vs. 10.5%, p = 0.005). When the OR smoothing curve was used to divide patients into three groups based on G8 scores of <10, 10-14, and > 14, we observed significant differences in complication rates among the groups (37.5% vs. 16.9%. vs. 10.5%; p = 0.001).Conclusion: The G8 can aid in predicting postoperative complications in patients >= 65 years old. Comprehensive geriatric assessment is warranted in patients with G8 scores <= 14 prior to major uro-oncologic surgery. Older pa-tients with G8 scores <10 should be counseled regarding the very high risk of surgery.(c) 2022 Published by Elsevier Ltd.