INTRODUCTIONMalignant bowel obstruction is common among patients with advanced malignancy with incidence rates of 28‐51% for gastrointestinal and gynecological cancers. This condition may signify a terminal event with an associated median life expectancy of 4 months. Therefore, goals of care for this high‐risk population are palliative requiring careful consideration of patient quality of life through either medical or surgical treatment approaches. Despite the potential palliative benefits of surgery for patients with malignant bowel obstruction, surgery is associated with rates of serious complications as high as 44%. Furthermore, these patients are at risk for prolonged hospitalization which may consume a considerable percentage of their limited life expectancy. Therefore, careful surgical risk stratification is essential for informed consent prior to proceeding with surgical intervention.Traditional methods of operative risk stratification include the American Society of Anesthesiologist (ASA) physical status classification and the Charlson comorbidity index (CCI). In addition, a growing body of research has demonstrated the use of measures of frailty, including the modified frailty index (mFI), to predict postoperative morbidity and mortality for numerous surgical interventions including pancreatectomy, hepatectomy, and colorectal surgery. Frailty is defined as decreased physiologic reserve and, therefore, increased vulnerability to disability due to inability to withstand stressors.
Journal of Surgical Oncology – Wiley
Published: Jan 1, 2018
Keywords: ; ; ; ;
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