International Journal of Gerontology
Effectiveness of Geriatric Assessment in Predicting Postoperative Morbidity after Laparoscopic Surgery in Older Patients: A Systematic Review
Supplementary MaterialNo data
The main aim was to review the results of studies investigating individual domains of geriatric assessment (GA), and GA as a whole, among older patients undergoing laparoscopic surgery. A systematic literature search was performed for papers published between 2009 and 2020. Ten studies were evaluated, including 1940 patients. The activities of daily living (ADL) or the instrumental activities of daily living (I-ADL), was used in 90% of studies, followed by the geriatric depression score (GDS) (80%), the Mini-Mental State Examination (MMSE) (70%), polypharmacy (70%), the Mini Nutritional Assessment (MNA) (60%), the Charlson Comorbidity Index (CCI) (50%), the cumulative illness rating scale (CIRS) (20%), the Blessed Orientation-Memory-Concentration (BOMC) score (10%) and the Clock Drawing Test (CDT) (10%). Only dependency in the functional domain could be recognized as a reliable risk factor for postoperative complications in the majority of the studies. All authors have confirmed the effectiveness of a cumulative GA (odds ratio 3.1-6.0). Cumulative GA is recommended to predict the morbidity of the older patient after laparoscopic surgery. For the individual domains (apart from physical function) the results are too inconsistent to reach any clinical conclusion.