What is the optimal risk scoring for predicting complications after colorectal surgery in elderly patients?

Background: Although several risk scoring systems that predict postoperative complication incidence are available, the optimal scoring tool for elderly colorectal cancer patients remains unknown. Material and Methods: Records of 659 patients underwent surgery for colorectal cancer were retrospectively reviewed, and 130 patients aged >80 years were divided into two groups according to postoperative complications (Clavien-Dindo classification ≥ grade II) as Complication group and Non-complication group.Scoring systems such as the Surgical Apgar score (SAS), and the Prognostic nutritional index (PNI), and sections of the Physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM; physiological score (PS-P), and operative severity score (OS-P)), the Colorectal POSSUM (CR-POSSUM; physiological score (PS-CP) and operative severity score (OS-CP)), and Estimating the physiologic ability and surgical stress score (E-PASS; preoperative risk score (PRS), surgical stress score (SSS) and comprehensive risk score (CRS)) were analyzed. Results: The PS-P, PRS, and CRS were significantly different between the two groups in univariate analysis. Area under the Receiver Operating Characteristic Curve of PRS was the highest among the scoring systems. Multivariate analysis also showed PRS was a useful risk scoring tool. Conclusions: PRS may be useful for predicting the occurrence of complications for colorectal cancer in elderly patients.