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Int J Colorectal Dis. 2009 Mar;24(3):311-6. doi: 10.1007/s00384-008-0603-0. Epub 2008 Oct 18.

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

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1
Department of Surgery, University Hospital Geneva, Geneva, Switzerland.

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 > or =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.

PMID:
18931847
DOI:
10.1007/s00384-008-0603-0
[Indexed for MEDLINE]
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