Postoperative transitional care needs in the elderly: An Outcome of recovery associated with worse long-term survival

Linda T. Li, Gala M. Barden, Courtney J. Balentine, Sonia T. Orcutt, Aanand D. Naik, Avo Artinyan, Shubhada Sansgiry, Daniel Albo, David H. Berger, Daniel A. Anaya

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: To characterize transitional care needs (TCNs) after colorectal cancer (CRC) surgery and examine their association with age and impact on overall survival (OS). Background: TCNs after cancer surgery represent additional burden for patients and are associated with higher short-term mortality. They are not wellcharacterized in CRC patients, particularly in the context of a growing elderly population, and their effect on long-term survival is unknown. Methods: A retrospective cohort study of CRC patients (N = 486) having curative surgery at a tertiary referral center (2002-2011) was conducted. Outcomes included TCNs (home health or nonhome destination at discharge) and OS. Patients were compared on the basis of age: young (<65 years), old (65-74 years), and oldest (≥75 years).Multivariate logistic regression models were used to examine the association of age with TCNs, and OS was compared on the basis of TCNs and stage, using the Kaplan-Meier method. Results: TCNs were required by 130 patients (27%). The oldest patients had highest TCNs (49%) compared with the other age groups (P < 0.01), with rehabilitation services as their primary TCNs (80%). After multivariate analysis, patients 75 years or older had significantly increased TCN risk (odds ratio, 4.7; 95% confidence interval, 2.6-8.5). TCN was associated with worse OS for patients with early- and advanced stage CRC (P < 0.001). Conclusions: TCNs after CRC surgery are common and significantly increased in patients 75 years or older, represent an outcome of postoperative recovery, and are associated with worse long-term survival. Preoperative identification of higher risk populations should be used for patient counseling, advanced preoperative planning, and to implement strategies targeted at minimizing TCNs.

Original languageEnglish (US)
Pages (from-to)695-701
Number of pages7
JournalAnnals of Surgery
Volume261
Issue number4
DOIs
StatePublished - Apr 1 2015
Externally publishedYes

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Postoperative Care
Survival
Colorectal Neoplasms
Colorectal Surgery
Transitional Care
Logistic Models
Odds Ratio
Tertiary Care Centers
Population
Counseling
Primary Health Care
Cohort Studies
Rehabilitation
Multivariate Analysis
Retrospective Studies
Age Groups
Confidence Intervals

Keywords

  • Elderly
  • Postoperative
  • Surgery
  • Survival
  • Transitional care needs

ASJC Scopus subject areas

  • Surgery

Cite this

Li, L. T., Barden, G. M., Balentine, C. J., Orcutt, S. T., Naik, A. D., Artinyan, A., ... Anaya, D. A. (2015). Postoperative transitional care needs in the elderly: An Outcome of recovery associated with worse long-term survival. Annals of Surgery, 261(4), 695-701. https://doi.org/10.1097/SLA.0000000000000673

Postoperative transitional care needs in the elderly : An Outcome of recovery associated with worse long-term survival. / Li, Linda T.; Barden, Gala M.; Balentine, Courtney J.; Orcutt, Sonia T.; Naik, Aanand D.; Artinyan, Avo; Sansgiry, Shubhada; Albo, Daniel; Berger, David H.; Anaya, Daniel A.

In: Annals of Surgery, Vol. 261, No. 4, 01.04.2015, p. 695-701.

Research output: Contribution to journalArticle

Li, LT, Barden, GM, Balentine, CJ, Orcutt, ST, Naik, AD, Artinyan, A, Sansgiry, S, Albo, D, Berger, DH & Anaya, DA 2015, 'Postoperative transitional care needs in the elderly: An Outcome of recovery associated with worse long-term survival', Annals of Surgery, vol. 261, no. 4, pp. 695-701. https://doi.org/10.1097/SLA.0000000000000673
Li, Linda T. ; Barden, Gala M. ; Balentine, Courtney J. ; Orcutt, Sonia T. ; Naik, Aanand D. ; Artinyan, Avo ; Sansgiry, Shubhada ; Albo, Daniel ; Berger, David H. ; Anaya, Daniel A. / Postoperative transitional care needs in the elderly : An Outcome of recovery associated with worse long-term survival. In: Annals of Surgery. 2015 ; Vol. 261, No. 4. pp. 695-701.
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title = "Postoperative transitional care needs in the elderly: An Outcome of recovery associated with worse long-term survival",
abstract = "Objective: To characterize transitional care needs (TCNs) after colorectal cancer (CRC) surgery and examine their association with age and impact on overall survival (OS). Background: TCNs after cancer surgery represent additional burden for patients and are associated with higher short-term mortality. They are not wellcharacterized in CRC patients, particularly in the context of a growing elderly population, and their effect on long-term survival is unknown. Methods: A retrospective cohort study of CRC patients (N = 486) having curative surgery at a tertiary referral center (2002-2011) was conducted. Outcomes included TCNs (home health or nonhome destination at discharge) and OS. Patients were compared on the basis of age: young (<65 years), old (65-74 years), and oldest (≥75 years).Multivariate logistic regression models were used to examine the association of age with TCNs, and OS was compared on the basis of TCNs and stage, using the Kaplan-Meier method. Results: TCNs were required by 130 patients (27{\%}). The oldest patients had highest TCNs (49{\%}) compared with the other age groups (P < 0.01), with rehabilitation services as their primary TCNs (80{\%}). After multivariate analysis, patients 75 years or older had significantly increased TCN risk (odds ratio, 4.7; 95{\%} confidence interval, 2.6-8.5). TCN was associated with worse OS for patients with early- and advanced stage CRC (P < 0.001). Conclusions: TCNs after CRC surgery are common and significantly increased in patients 75 years or older, represent an outcome of postoperative recovery, and are associated with worse long-term survival. Preoperative identification of higher risk populations should be used for patient counseling, advanced preoperative planning, and to implement strategies targeted at minimizing TCNs.",
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T2 - An Outcome of recovery associated with worse long-term survival

AU - Li, Linda T.

AU - Barden, Gala M.

AU - Balentine, Courtney J.

AU - Orcutt, Sonia T.

AU - Naik, Aanand D.

AU - Artinyan, Avo

AU - Sansgiry, Shubhada

AU - Albo, Daniel

AU - Berger, David H.

AU - Anaya, Daniel A.

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Objective: To characterize transitional care needs (TCNs) after colorectal cancer (CRC) surgery and examine their association with age and impact on overall survival (OS). Background: TCNs after cancer surgery represent additional burden for patients and are associated with higher short-term mortality. They are not wellcharacterized in CRC patients, particularly in the context of a growing elderly population, and their effect on long-term survival is unknown. Methods: A retrospective cohort study of CRC patients (N = 486) having curative surgery at a tertiary referral center (2002-2011) was conducted. Outcomes included TCNs (home health or nonhome destination at discharge) and OS. Patients were compared on the basis of age: young (<65 years), old (65-74 years), and oldest (≥75 years).Multivariate logistic regression models were used to examine the association of age with TCNs, and OS was compared on the basis of TCNs and stage, using the Kaplan-Meier method. Results: TCNs were required by 130 patients (27%). The oldest patients had highest TCNs (49%) compared with the other age groups (P < 0.01), with rehabilitation services as their primary TCNs (80%). After multivariate analysis, patients 75 years or older had significantly increased TCN risk (odds ratio, 4.7; 95% confidence interval, 2.6-8.5). TCN was associated with worse OS for patients with early- and advanced stage CRC (P < 0.001). Conclusions: TCNs after CRC surgery are common and significantly increased in patients 75 years or older, represent an outcome of postoperative recovery, and are associated with worse long-term survival. Preoperative identification of higher risk populations should be used for patient counseling, advanced preoperative planning, and to implement strategies targeted at minimizing TCNs.

AB - Objective: To characterize transitional care needs (TCNs) after colorectal cancer (CRC) surgery and examine their association with age and impact on overall survival (OS). Background: TCNs after cancer surgery represent additional burden for patients and are associated with higher short-term mortality. They are not wellcharacterized in CRC patients, particularly in the context of a growing elderly population, and their effect on long-term survival is unknown. Methods: A retrospective cohort study of CRC patients (N = 486) having curative surgery at a tertiary referral center (2002-2011) was conducted. Outcomes included TCNs (home health or nonhome destination at discharge) and OS. Patients were compared on the basis of age: young (<65 years), old (65-74 years), and oldest (≥75 years).Multivariate logistic regression models were used to examine the association of age with TCNs, and OS was compared on the basis of TCNs and stage, using the Kaplan-Meier method. Results: TCNs were required by 130 patients (27%). The oldest patients had highest TCNs (49%) compared with the other age groups (P < 0.01), with rehabilitation services as their primary TCNs (80%). After multivariate analysis, patients 75 years or older had significantly increased TCN risk (odds ratio, 4.7; 95% confidence interval, 2.6-8.5). TCN was associated with worse OS for patients with early- and advanced stage CRC (P < 0.001). Conclusions: TCNs after CRC surgery are common and significantly increased in patients 75 years or older, represent an outcome of postoperative recovery, and are associated with worse long-term survival. Preoperative identification of higher risk populations should be used for patient counseling, advanced preoperative planning, and to implement strategies targeted at minimizing TCNs.

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KW - Postoperative

KW - Surgery

KW - Survival

KW - Transitional care needs

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