The association of postoperative morbidity and age on 5-year survival after colorectal surgery in the elderly population: a nationwide cohort study.

AIM: This study aimed to evaluate the association of age and postoperative morbidity on 5-year overall survival (OS) after elective surgery for colorectal cancer. METHOD: Patients undergoing elective, curatively intended surgery for colorectal cancer Union for International Cancer Control Stages I-III between January 2014 and December 2019 were selected from four Danish nationwide healthcare databases. Patients were divided into four groups: group I 65-69 years old; group II 70-74 years old; group III 75-79 years old; and group IV ≥80 years old. Propensity score matching was used to reduce potential confounding bias. The primary outcome was the association of age and postoperative morbidity with 5-year OS. The secondary outcome was conditional survival, given that the patient had already survived the first 90 days after surgery. RESULTS: After propensity score matching with a 1:1 ratio, group II contained 2221 patients; group III 952 patients; and group IV 320 patients. There was no significant difference in 5-year OS between group I (reference) and groups II and III (P = 0.4 and P = 0.9, respectively). Patients with severe postoperative complications within 30 days after surgery had a significantly decreased OS (P < 0.01); however, when patients who died within the first 90 days were excluded from the analysis, the differences in 5-year OS were less pronounced across all age groups. CONCLUSION: Postoperative morbidity, and not patient age, was associated with a lower 5-year OS. Long-term survival for patients who experience a complication is similar to patients who did not have a complication when conditioning on 90 days of survival.

Prevalence and population characteristics associated with frailty in a rural low socioeconomic area in Denmark: the Lolland-Falster Health Study.

BACKGROUND: Frailty is a major geriatric syndrome that predicts increased vulnerability to minor stressor events and adverse outcomes such as falls, fractures, disability and death. The prevalence of frailty among individuals above the age of 65 varies widely with an overall weighted prevalence of 10.7%. OBJECTIVES: The purpose of this study was to examine the prevalence of prefrailty and frailty in community-dwelling older adults from the regions of Lolland-Falster, which is one of the most socioeconomically disadvantaged areas of Denmark with lower income and lower life expectancy compared with the general Danish population. Moreover, the objective was to find selected individual characteristics associated with frailty. DESIGN: An observational, cross-sectional registry-based population study with data from the regions of Lolland-Falster collected between February 2016 and February 2020. RESULTS: The study included 19 000 individuals. There were 10 154 above the age of 50 included for analysis. Prevalence of frailty in the age group of 50-64 years was 4.7% and 8.7% in the age group of 65 years and above.The study demonstrates associations between frailty and high age, female gender, low education level, low income, smoking, living alone, frequency of seeing one's children and getting help when needed. These associations are comparable with findings from other studies. CONCLUSION: The syndrome of frailty consists of not only physiological and medical issues but also education, life conditions such as living alone and living in poverty and how you evaluate your own health.

Prevalence of sarcopenia in a Danish geriatric out-patient population.

INTRODUCTION: The prevalence of sarcopenia varies extensively depending on the definitions and studied populations. The aim of this study was to assess the prevalence of sarcopenia in a Danish geriatric out-patient population using criteria from the European Working Group on Sarcopenia (EWGSOP). METHODS: Patients referred to a geriatric out-patientclinic were included. Using the EWGSOP´s recommendations, appendicular skeletal muscle mass (ASM), hand-grip strength (HGS) and gait speed (ten-meter walk (GS)) were assessed. Skeletal muscle mass index (SMI) was calculated by ASM/height2 (kg/m2), and patients were classified with: no sarcopenia (normal SMI), pre-sarcopenia (reduced SMI, normal HGS and GS), sarcopenia (reduced SMI and reduced HGS or GS) or severe sarcopenia (reduced SMI, HGS and GS). RESULTS: A total of 189 patients were screened, 80 were included. In all, 12 (15%) had severe sarcopenia, nine (11%) sarcopenia, eight (10%) pre-sarcopenia and 51 (64%) no sarcopenia. Mean age was significantly higher in the SARC- group (sarcopenia and severe sarcopenia) than in the NOSARC-group (pre-sarcopenia and no sarcopenia) (p = 0.009), and BMI was significantly lower in the SARC-group (p < 0.0001). No difference was found in gender distribution (p = 0.729). CONCLUSIONS: 26% of patients in a geriatric out-patient population had sarcopenia, which highlights that this is a common condition. Standard assessments can identify functional limitations, but not sarcopenia. The EWGSOP's recommendations are feasible, and we suggest that they should form part of the standard clinical comprehensive geriatric assessment. FUNDING: none. TRIAL REGISTRATION: not relevant.