Postoperative mortality risk factors in colorectal cancer: Follow up of a cohort in a specialised unit

Errasti Alustiza, José; Cermeño Toral, Baltasar; Campo Cimarras, Eugenia; Romeo Ramírez, José Antonio; Sardón Ramos, José Domingo; Reka Mediavilla, Lorena; Arrillaga Alcorta, Iratxe; Parraza Díez, Naiara

doi:10.1016/S2173-5077(10)70169-1

Información del artículo

Resumen

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Abstract

Introduction

The treatment of colorectal cancer (CRC) is usually surgical and involves morbidity-mortality. The aim of this study is to quantify the postoperative mortality in our hospital and to determine their risk factors.

Materials and methods

Prospective observational study from 1996 to 2007 included 1017 patients who underwent surgery for CRC in our hospital. Identification of independent risk factors for postoperative mortality by multivariate analysis.

Results

The mean age was 67.8 years. The surgery was elective in 879 (86.5%) and was considered curative in 878 (86.1%). The postoperative mortality was 3.6% (37 patients), 2.5% in the elective surgery, and 10.9% in the urgent.

The independent risk factors identified were: type of surgery (odds ratio for urgent vs elective=2.8), American Society of Anesthesiologists (ASA) grade (odds ratio for ASA III–IV vs I–II=2.4), age (odds ratio for age ≥85 vs ≤74=7.6 and age 75–84 vs ≤74=2.4).

Conclusions

We found a low postoperative mortality, which was mainly associated with age over 75 years, ASA III or IV stages, and urgent surgery.

Keywords:

Colorectal neoplasms

Colorectal cancer

Colorectal surgery

Mortality

Clinícal audit

Standards

Resumen

Introducción

El tratamiento del cancer colorrectal (CCR) es habitualmente quirúrgico y conlleva una morbimortalidad. El objetivo de este estudio es cuantificar la mortalidad postoperatoria en nuestro hospital y determinar sus factores de riesgo.

Material y método

Estudio prospectivo observacional de los 1.017 pacientes operados en nuestro hospital por CCR desde 1996 hasta 2007. Identificación de factores de riesgo independientes de mortalidad postoperatoria mediante estudio multivariante.

Resultados

La edad media era de 67,8 años. La cirugía se programó en 879 pacientes (86,5%) y se consideró curativa en 878 (86,1%). La mortalidad postoperatoria fue del 3,6% (37 pacientes) (el 2,5% en la cirugía programada y el 10,9% en la cirugía urgente). Los factores de riesgo independientes identificados fueron el tipo de cirugía (odds ratio [OR] para urgente versus programada=2,8), el grado de la American Society of Anesthesiologists (ASA) (OR para ASA III–IV versus ASA I–II=2,4) y la edad (OR para edad ≥85 versus ≤74=7,6 y edad 75–84 versus ≤74=2,4).

Conclusiones

Tenemos una baja mortalidad postoperatoria que se asocia principalmente a una edad mayor de 75 años, a los grados ASA III–IV y a la cirugía urgente.

Palabras clave:

Neoplasia colorrectal

Cáncer colorrectal

Cirugía colorrectal

Mortalidad

Auditoría clínica

Estándares

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