Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients

EROL, Timuçin; Abbasoglu, Osman; Şengül Ayçiçek, Gözde; Halil, Meltem; DENİZ, OLGUN; Ünsal, Pelin

doi:10.3906/sag-2012-242

Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients

Gozde SENGUL AYCICEK, (Hacettepe Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Geriatri Anabilim Dalı, Ankara, Türkiye)

Timuçin EROL, (Hacettepe Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Ankara, Türkiye)

Pelin ÜNSAL, (Hacettepe Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Geriatri Anabilim Dalı, Ankara, Türkiye)

Olgun DENİZ, (Hacettepe Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Geriatri Anabilim Dalı, Ankara, Türkiye)

Osman ABBASOĞLU, (Hacettepe Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Ankara, Türkiye)

Meltem HALİL (Hacettepe Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Geriatri Anabilim Dalı, Ankara, Türkiye)

Turkish Journal of Medical Sciences

1 0

Yıl: 2021 Cilt: 51 Sayı: 3 Sayfa Aralığı: 1261 - 1266 Metin Dili: İngilizce DOI: 10.3906/sag-2012-242 İndeks Tarihi: 18-01-2022

Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients

Öz:

Background/aim: Gastrointestinal (GI) system cancers are frequent among older adults and it is still difficult to predict which are at increased risk for postoperative complications. Frailty and sarcopenia are increasing problems of older population and may be associated with adverse outcomes. In this study we aimed to examine the effect of sarcopenia and frailty on postoperative complications in older patients undergoing surgery for GI cancers. Materials and methods: Forty-nine patients admitted to general surgery clinic with the diagnosis of gastrointestinal system cancers were included in this cross-sectional study. Frailty status was assessed using the Edmonton Frail Scale (EFS). Sarcopenia was defined due to the EWGSOP2 criteria and ultrasonography was used to evaluate muscle mass. Results: The median age of the patients was 70 (min-max: 65–87). Fourteen (28.6%) patients were found to be sarcopenic and 16 (32.7%) patients were frail, and 6 (37.5%) of these patients were also severe sarcopenic (p = 0.04). When the postoperative complications were assessed, time to oral intake, time to enough oral intake, length of hospital stay in the postoperative period were found to be longer in frail patients (p = 0.02, p = 0.03, p = 0.04 respectively). Postoperative complications were not different due to the sarcopenia. Conclusion: Frailty, but not sarcopenia was associated with adverse outcomes in older adults undergoing GI cancer surgery. Comprehensive geriatric assessment before surgical intervention may help to identify patients who are at risk.Key words: Frailty, gastrointestinal cancer, older adults, sarcopenia, ultrasonography

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018; 68 (6): 394-424. doi: 10.3322/caac.21492
2. Partridge JS, Harari D, Dhesi JK. Frailty in the older surgical patient: a review. Age Ageing 2012; 41 (2): 142-147. doi: 10.1093/ageing/afr182
3. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet (London, England) 2013; 381 (9868): 752-762. doi: 10.1016/S0140-6736(12)62167-9
4. Boakye D, Rillmann B, Walter V, Jansen L, Hoffmeister M et al. Impact of comorbidity and frailty on prognosis in colorectal cancer patients: a systematic review and meta-analysis. Cancer Treatment Reviews. 2018; 64: 30-39. doi: 10.1016/j. ctrv.2018.02.003
5. Beaudart C, Zaaria M, Pasleau F, Reginster J-Y, Bruyère O. Health outcomes of sarcopenia: a systematic review and meta-analysis. PloS One 2017; 12 (1): e0169548. doi: 10.1371/ journal.pone.0169548
6. Tosato M, Marzetti E, Cesari M, Savera G, Miller RR et al. Measurement of muscle mass in sarcopenia: from imaging to biochemical markers. Aging Clinical and Experimental Research 2017; 29 (1): 19-27. doi: 10.1007/s40520-016-0717-0
7. Nijholt W, Scafoglieri A, Jager-Wittenaar H, Hobbelen JS, Van der Schans CP. The reliability and validity of ultrasound to quantify muscles in older adults: a systematic review. Journal of Cachexia, Sarcopenia and Muscle 2017; 8 (5): 702-712. doi: 10.1002/jcsm.12210
8. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T et al. Sarcopenia: European consensus on definition and diagnosis. Report of the European Working Group on Sarcopenia in older people. Age Ageing 2010; 39 (4): 412-423. doi: 10.1093/ageing/afq034
9. Shachar SS, Williams GR, Muss HB, Nishijima TF. Prognostic value of sarcopenia in adults with solid tumours: a metaanalysis and systematic review. European Journal of Cancer (Oxford, England : 1990). 2016; 57: 58-67. doi: 10.1016/j. ejca.2015.12.030
10. Kazemi-Bajestani SM, Mazurak VC, Baracos V. Computed tomography-defined muscle and fat wasting are associated with cancer clinical outcomes. Seminars in Cell & Developmental Biology 2016; 54: 2-10. doi: 10.1016/j.semcdb.2015.09.001
11. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C et al. Frailty in older adults: evidence for a phenotype. The Journals of Gerontology Series A, Biological Sciences and Medical Sciences 2001; 56 (3): M146-156. doi: 10.1093/gerona/56.3.m146
12. Turner G, Clegg A. Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report. Age Ageing 2014; 43 (6): 744-747. doi: 10.1093/ageing/afu138
13. Buta BJ, Walston JD, Godino JG, Park M, Kalyani RR et al. Frailty assessment instruments: systematic characterization of the uses and contexts of highly-cited instruments. Ageing Research Reviews 2016; 26: 53-61. doi: 10.1016/j. arr.2015.12.003
14. Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age Ageing 2006; 35 (5): 526-529. doi: 10.1093/ageing/afl041
15. Aygör HE, Fadıloğlu Ç, Şahin S, Aykar F, Akçiçek F. Validation of Edmonton Frail Scale into elderly Turkish population. Archives of Gerontology and Geriatrics 2018; 76: 133-137. doi: 10.1016/j.archger.2018.02.003
16. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition (Burbank, Los Angeles County, Calif) 1999; 15 (2): 116-122. doi: 10.1016/s0899-9007(98)00171-3
17. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. the index of adl: a standardized measure of biological and psychosocial function. The Journal of the American Medical Association 1963; 185: 914-919. doi: 10.1001/jama.1963.03060120024016
18. Arik G, Varan HD, Yavuz BB, Karabulut E, Kara O et al. Validation of Katz index of independence in activities of daily living in Turkish older adults. Archives of Gerontology and Geriatrics 2015; 61 (3): 344-350. doi: 10.1016/j. archger.2015.08.019
19. Lawton MP, Brody EM. Assessment of older people: selfmaintaining and instrumental activities of daily living. The Gerontologist 1969; 9 (3): 179-186. PMID: 5349366
20. Isik EI, Yilmaz S, Uysal I, Basar S. Adaptation of the Lawton instrumental activities of daily living scale to Turkish: validity and reliability study. Annals of Geriatric Medicine and Research 2020; 24 (1): 35-40. doi: 10.4235/agmr.19.0051
21. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 1975; 12 (3): 189- 198. doi: 10.1016/0022-3956(75)90026-6
22. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V et al. Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research. 1982; 17 (1): 37-49. doi: 10.1016/0022-3956(82)90033-4
23. Bahat G, Tufan A, Tufan F, Kilic C, Akpinar TS et al. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in older people (EWGSOP) definition. Clinical Nutrition (Edinburgh, Scotland) 2016; 35 (6): 1557- 1563. doi: 10.1016/j.clnu.2016.02.002
24. Perkisas S, Bastijns S, Sanchez-Rodriguez D, Piotrowicz K, De Cock AM. Application of ultrasound for muscle assessment in sarcopenia: 2020 SARCUS update: reply to the letter to the editor: SARCUS working group on behalf of the Sarcopenia Special Interest Group of the European Geriatric Medicine Society. European Geriatric Medicine 2021; 12 (2): 427-428. doi: 10.1007/s41999-021-00462-y
25. Wilson A, Hides JA, Blizzard L, Callisaya M, Cooper A et al. Measuring ultrasound images of abdominal and lumbar multifidus muscles in older adults: a reliability study. Manual Therapy 2016; 23: 114-119. doi: 10.1016/j.math.2016.01.004
26. Shahtahmassebi B, Hebert JJ, Hecimovich MD, Fairchild TJ. Associations between trunk muscle morphology, strength and function in older adults. Scientific Reports 2017; 7 (1): 1-10. doi: 10.1038/s41598-017-11116-0
27. Wagner D, DeMarco MM, Amini N, Buttner S, Segev D et al. Role of frailty and sarcopenia in predicting outcomes among patients undergoing gastrointestinal surgery. World Journal of Gastrointestinal Surgery 2016; 8 (1): 27-40. doi: 10.4240/wjgs. v8.i1.27
28. Makary MA, Segev DL, Pronovost PJ, Syin D, Bandeen-Roche K et al. Frailty as a predictor of surgical outcomes in older patients. Journal of the American College of Surgeons 2010; 210 (6): 901-908. doi: 10.1016/j.jamcollsurg.2010.01.028
29. Englesbe MJ, Patel SP, He K, Lynch RJ, Schaubel DE et al. Sarcopenia and mortality after liver transplantation. Journal of the American College of Surgeons 2010; 211 (2): 271-278. doi: 10.1016/j.jamcollsurg.2010.03.039
30. Amini N, Spolverato G, Gupta R, Margonis GA, Kim Y et al. Impact total psoas volume on short- and long-term outcomes in patients undergoing curative resection for pancreatic adenocarcinoma: a new tool to assess sarcopenia. Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract 2015; 19 (9): 1593-1602. doi: 10.1007/s11605-015-2835-y

APA	Şengül Ayçiçek G, EROL T, Ünsal P, DENİZ O, Abbasoglu O, Halil M (2021). Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. , 1261 - 1266. 10.3906/sag-2012-242
Chicago	Şengül Ayçiçek Gözde,EROL Timuçin,Ünsal Pelin,DENİZ OLGUN,Abbasoglu Osman,Halil Meltem Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. (2021): 1261 - 1266. 10.3906/sag-2012-242
MLA	Şengül Ayçiçek Gözde,EROL Timuçin,Ünsal Pelin,DENİZ OLGUN,Abbasoglu Osman,Halil Meltem Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. , 2021, ss.1261 - 1266. 10.3906/sag-2012-242
AMA	Şengül Ayçiçek G,EROL T,Ünsal P,DENİZ O,Abbasoglu O,Halil M Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. . 2021; 1261 - 1266. 10.3906/sag-2012-242
Vancouver	Şengül Ayçiçek G,EROL T,Ünsal P,DENİZ O,Abbasoglu O,Halil M Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. . 2021; 1261 - 1266. 10.3906/sag-2012-242
IEEE	Şengül Ayçiçek G,EROL T,Ünsal P,DENİZ O,Abbasoglu O,Halil M "Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients." , ss.1261 - 1266, 2021. 10.3906/sag-2012-242
ISNAD	Şengül Ayçiçek, Gözde vd. "Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients". (2021), 1261-1266. https://doi.org/10.3906/sag-2012-242

APA	Şengül Ayçiçek G, EROL T, Ünsal P, DENİZ O, Abbasoglu O, Halil M (2021). Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. Turkish Journal of Medical Sciences, 51(3), 1261 - 1266. 10.3906/sag-2012-242
Chicago	Şengül Ayçiçek Gözde,EROL Timuçin,Ünsal Pelin,DENİZ OLGUN,Abbasoglu Osman,Halil Meltem Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. Turkish Journal of Medical Sciences 51, no.3 (2021): 1261 - 1266. 10.3906/sag-2012-242
MLA	Şengül Ayçiçek Gözde,EROL Timuçin,Ünsal Pelin,DENİZ OLGUN,Abbasoglu Osman,Halil Meltem Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. Turkish Journal of Medical Sciences, vol.51, no.3, 2021, ss.1261 - 1266. 10.3906/sag-2012-242
AMA	Şengül Ayçiçek G,EROL T,Ünsal P,DENİZ O,Abbasoglu O,Halil M Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. Turkish Journal of Medical Sciences. 2021; 51(3): 1261 - 1266. 10.3906/sag-2012-242
Vancouver	Şengül Ayçiçek G,EROL T,Ünsal P,DENİZ O,Abbasoglu O,Halil M Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients. Turkish Journal of Medical Sciences. 2021; 51(3): 1261 - 1266. 10.3906/sag-2012-242
IEEE	Şengül Ayçiçek G,EROL T,Ünsal P,DENİZ O,Abbasoglu O,Halil M "Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients." Turkish Journal of Medical Sciences, 51, ss.1261 - 1266, 2021. 10.3906/sag-2012-242
ISNAD	Şengül Ayçiçek, Gözde vd. "Impact of frailty and ultrasonography-based sarcopenia on the development of postoperative complications in gastrointestinal cancer patients". Turkish Journal of Medical Sciences 51/3 (2021), 1261-1266. https://doi.org/10.3906/sag-2012-242