Here - American Geriatrics Society

P OSTER
A BSTRACTS
Results: Regional anesthesia as compared to general anesthesia
did not carry excess mortality risk in elderly patients 90 and above (p
= 0.43). There was no association between the type of anesthesia used
and the rate of post-operative complications. The relationship of age
and the type of anesthesia used were also considered. Within this age
group, the choice of anesthesia did not seem to depend on a patient’s
age (p = 0.51).
Conclusion: The type of anesthesia, whether regional or general,
does not affect outcomes in elderly patients undergoing surgery for
hip fractures. Therefore, greater utilization of regional anesthesia in
this population may be a cost effective option, as it deters the need
for extensive preoperative evaluations.
C41
Translating Geriatric Assessment into Community Oncology Clinics:
Comparative Results.
G. R. Williams, 1 A. Deal, 2,3 T. Jolly, 4 S. Alston, 2 B. Gordon, 2 J. Pan, 2
A. Caprio, 1 S. Moore, 5 W. Taylor, 6 H. Muss. 2,4 1. Division of Geriatric
Medicine and Center for Aging and Health, University of North
Carolina at Chapel Hill, Chapel Hill, NC; 2. Lineberger
Comprehensive Cancer Center, University of North Carolina at
Chapel Hill, Chapel Hill, NC; 3. Biostatistics Core Faculty, University
of North Carolina at Chapel Hill, Chapel Hill, NC; 4. Division of
Hematology / Oncology, University of North Carolina at Chapel Hill,
Chapel Hill, NC; 5. Rex Hematology Oncology Associates, Raleigh,
NC; 6. New Bern Cancer Care, New Bern, NC.
Supported By: Supported by University Cancer Research Fund,
Lineberger Comprehensive Cancer Center, Chapel Hill, NC
Background: Emerging results support the value of geriatric assessment
(GA) in determining the risk and benefits of cancer treatment
in older adults. A brief GA tool consisting of valid and reliable
measures has been developed (Hurria et al, J Clin Oncol 29:1290,
2011), but little data exist on the GA of elderly patients in the community.
This study compares the differences between geriatric oncology
patients at academic versus community based oncology practices
in North Carolina.
Methods: From 2009 to 2011 a total of 386 patients were recruited.
283 (73%) were from a tertiary care referral cancer center
(UNC) and 103 (27%) were from community clinics. The two groups
were compared using Fisher’s Exact and Wilcoxon rank sum tests.
Results: Community clinics enrolled older patients (p= 0.004),
with 52% being ≥ 75 years of age, compared to only 33% at UNC. The
Karnofsky performance status as rated by medical staff was significantly
lower at community clinics (60% vs 25% with a score ≤ 90%;
p= 65 years of age hospitalized with pneumonia during fiscal
years 2002 to 2007 in Department of Veterans Affairs hospitals.
Our primary analyses were multilevel regression models that examined
the association between cardiovascular medication classes and
either 90-day mortality or cardiovascular events within 90-days after
adjusting for potential confounders.
Results: Our cohort included 50,064 patients with a mean age of
77.3 years, 98% were male, 23% died within 90 days of admission, and
38% had a cardiac event. Medications associated with decreased
mortality include beta-blockers (OR 0.92, 95% CI 0.87-0.97), statins
(OR 0.67, 95% CI 0.63-0.70), ACE inhibitors (OR 0.81, 95% CI 0.76-
0.86), and ARBs (OR 0.61, 95% CI 0.53-0.70), but an increased number
of cardiovascular events: beta-blockers (OR 1.15, 95% CI 1.10-
1.21), statins (OR 1.02, 95% CI 0.98-1.07), ACE inhibitors (OR 1.14,
95% CI 1.09-1.20), and ARBs (OR 1.20 95% CI 1.08-1.33).
S146
AGS 2012 ANNUAL MEETING