Abstract
ABSTRACT
Objectives
Endoscopic resection (ER) is used in older patients to treat upper gastrointestinal (UGI) neoplasms due to minimal invasiveness and excellent short‐term therapeutic outcomes. However, its impact on functional outcomes remains unclear. This study aimed to identify functional‐decline predictors post‐ER in older patients.
Methods
This prospective, single‐center cohort study included patients aged ≥75 years undergoing ER for UGI neoplasms between April 2017 and December 2021. Cognitive and physical functions were assessed using the Mini‐Mental State Examination (MMSE) and Instrumental Activities of Daily Living (IADL) scales, before and 6–9 months post‐ER. Functional decline was defined as a decrease of ≥3 points in MMSE or ≥1 point in IADL. Scores of geriatric assessment tools, including the Geriatric 8 (G8), Vulnerable Elders Survey‐13 (VES‐13), Flemish Triage Risk Screening Tool, and Mini‐Cognitive Assessment Instrument (Mini‐Cog), were evaluated as potential functional‐decline predictors.
Results
Of 202 patients, 37 (18.3%) experienced functional decline post‐ER. In multivariate analysis, poor G8 scores (≤14) were independent risk factors for functional decline (odds ratio: 2.64, 95% confidence interval: 1.02–6.84,
p
= 0.0461). Functional‐decline incidence gradually increased as G8 scores decreased (
p
= 0.0086, trend test).
Conclusions
Preoperative G8 scores may serve as functional‐decline predictors in older patients undergoing ER for UGI neoplasms. A preoperative G8 assessment could facilitate risk‐based treatment decisions from the perspective of functional outcomes in this vulnerable population.