Fulltext

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

Skala, K. ; Gervaz, P. ; Buchs, N. ; Inan, I. ; Secic, M. ; Mugnier-Konrad, B. ; Morel, P.

In: International Journal of Colorectal Disease, 2009, vol. 24, no. 3, p. 311-316

Zum persönliche Liste hinzufügen
    Titel
    • Risk factors for mortality-morbidity after emergency-urgent colorectal surgery
    Autor
    • Skala, K.. Department of Surgery, University Hospital Geneva, Geneva, Switzerland
    • Gervaz, P.. Department of Surgery, University Hospital Geneva, Geneva, Switzerland
    • Buchs, N.. Department of Surgery, University Hospital Geneva, Geneva, Switzerland
    • Inan, I.. Department of Surgery, University Hospital Geneva, Geneva, Switzerland
    • Secic, M.. Secic Statistical Consulting, Inc., Chardon, OH, USA
    • Mugnier-Konrad, B.. Department of Surgery, University Hospital Geneva, Geneva, Switzerland
    • Morel, P.. Department of Surgery, University Hospital Geneva, Geneva, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • International Journal of Colorectal Disease, 2009, vol. 24, no. 3, p. 311-316. Springer-Verlag
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:313820
    Summary
    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 >500cm3 (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