Impact of American College of Surgeons Geriatric Surgery Verification Program in Patients Undergoing Major Abdominal Oncologic Operation at a Cancer Center.

Abstract

Patients older than 65 years have unique needs and treatment outcome goals. The objective of this study was to evaluate the impact of Geriatric Surgery Verification (GSV) initiative in oncology patients 65 years or older undergoing major abdominal operation. We implemented the American College of Surgeons GSV program protocols for patients 65 years and older starting in 2022. A retrospective review was conducted of patients undergoing major abdominal oncologic operation from January 2021 through December 2022 to create pre-GSV and post-GSV initiative cohorts. Main outcome variables were postoperative institutionalization and change in the patient's primary residence disposition (measured as Primary Residence Score as a proxy for loss of independence). A total of 57 patients in the control group and 43 patients in the intervention group met inclusion criteria. The average age was 76.5 and 75 years, respectively. Patients were well matched for clinical and sociodemographic characteristics. The intervention group had a shorter mean length of stay (4.4 ± 2.5 days vs 6.5 ± 3.6 days in the control group [p < 0.01]) and were less likely to be newly discharged to an institution (7.3% vs 24.1%, p = 0.03). The GSV initiative was associated with 72% lower odds of increased Primary Residence Score (ie care needs) at time of discharge (odds ratio 0.28, 95% CI 0.1 to 0.81). The GSV initiative intervention in geriatric oncology patients undergoing major abdominal operation was associated with reducing postoperative institutionalization and change in primary residence disposition. Further studies to explore different mechanisms within GSV that lead to improved outcomes in geriatric oncologic population will be informative.