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Risk factors for mortality-morbidity after emergency-urgent colorectal surgery

Secic, M.
Mugnier-Konrad, B.
Published in International Journal of Colorectal Disease. 2009, vol. 24, no. 3, p. 311-316
Collection Open Access - Licence nationale Springer
Abstract BACKGROUND: The aim of this study was to assess the risk factors associated with mortality and morbidity following emergency or urgent colorectal surgery. MATERIALS AND METHODS: All data regarding the 462 patients who underwent emergency colonic resection in our institution between November 2002 and December 2007 were prospectively entered into a computerized database. RESULTS: The median age of patients was 73 (range 17-98) years. The most common indications for surgery were: 171 adenocarcinomas (37%), 129 complicated diverticulitis (28%), and 35 colonic ischemia (7.5%). Overall mortality and morbidity rates were 14% and 36%, respectively. In multivariate analysis, the only parameter significantly associated with postoperative mortality was blood loss >500 cm(3) (odds ratio (OR) = 3.33, 95% confidence interval (CI) 1.63-6.82, p = 0.001). There were three parameters which correlated with postoperative morbidity: ASA score ≥ 3 (OR = 2.9, 95% CI 1.9-4.5, p < 0.001), colonic ischemia (OR = 3.4, 95% CI 1.4-7.7, p = 0.006), and stoma creation (OR = 2.2, 95% CI 1.4-3.4, p = 0.0003). CONCLUSIONS: The main risk factors for postoperative morbidity and mortality following emergency colorectal surgery are related to: (1) patients' ASA score, (2) colonic ischemia, and (3) perioperative bleeding. These variables should be considered in the elaboration of future scoring systems to predict outcome of emergency colorectal surgery.
Keywords AdolescentAdultAgedAged, 80 and overColorectal Surgery/*mortality/*statistics & numerical dataDemography*Emergency TreatmentFemaleHumansMaleMiddle AgedMorbidityMultivariate AnalysisRisk FactorsSwitzerland/epidemiology
PMID: 18931847
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Research groups Chirurgie viscérale (104)
Chirurgie viscérale (HUG)
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SKALA, Karel et al. Risk factors for mortality-morbidity after emergency-urgent colorectal surgery. In: International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery, 2009, vol. 24, n° 3, p. 311-316. doi: 10.1007/s00384-008-0603-0 https://archive-ouverte.unige.ch/unige:20110

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Deposited on : 2012-04-23

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