English

Abstract

BACKGROUND Comorbidity in elderly has negative impact on physiological and cognitive functions, the prevalence of which is increasing. Management of multiple comorbidities has resulted in polypharmacy in elderly. Comorbidity Polypharmacy Score (CPS) is a clinical tool to quantify severity of comorbidities using polypharmacy as surrogate for intensity of treatment required to adequately manage comorbidities. We wanted to evaluate CPS as predictor of post-operative outcomes in geriatric patients undergoing elective surgeries. METHODS A prospective observational study was conducted in a tertiary care centre among elderly patients (more than 65 years) undergoing elective surgeries satisfying inclusion criteria. Calculated sample size was 250. CPS was calculated by assigning one point to each comorbidity and medication taken and sum calculated was categorised. Primary outcomes were defined by hospital length of stay and Barthel index at day 3 and day 5. RESULTS We found moderate positive correlation using Pearson Correlation with CPS and Barthel index at day 3 (p - value = 0.0024, correlation coefficient = - 0.191) and day 5 (p - value = 0.0013, correlation coefficient= -0.202). ANOVA test was applied to compare age with Barthel index at day 3 (p - value = 0.0005) and day 5 (p - value < 0.0001) which was statistically significant. Advanced age was not associated with longer Length of Stay (LOS) (p - value = 0.32). CPS was also not associated with longer LOS (p - value = 0.821). CONCLUSIONS CPS is an easy to measure tool for the evaluation of elderly surgical patients. CPS can be used to predict recovery in terms of activities of daily living (ADL) after surgery thereby preparing patient and family to cope up with stress of surgery and its financial and psychological outcomes. KEYWORDS Geriatric Anaesthesia, Comorbidity-Polypharmacy Score, Activities of Daily Living, Length of Stay, Barthel Index