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Article scientifique
Accès libre
Anglais

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

Publié dansInternational journal of colorectal disease, vol. 24, no. 3, p. 311-316
Collection
  • Open Access - Licence nationale Springer
Date de publication2009
Résumé

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.

Mots-clés
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Surgery/*mortality/*statistics & numerical data
  • Demography
  • *Emergency Treatment
  • Female
  • Humans
  • Male
  • Middle Aged
  • Morbidity
  • Multivariate Analysis
  • Risk Factors
  • Switzerland/epidemiology
Citation (format ISO)
SKALA, Karel et al. Risk factors for mortality-morbidity after emergency-urgent colorectal surgery. In: International journal of colorectal disease, 2009, vol. 24, n° 3, p. 311–316. doi: 10.1007/s00384-008-0603-0
Fichiers principaux (1)
Article (Published version)
accessLevelPublic
Identifiants
ISSN du journal0179-1958
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