Adarsh Hegde1, Nalini Kotekar2
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.
