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Title: Short-term outcome of emergency colorectal cancer surgery: results from Bi-National Colorectal Cancer Audit.
Epworth Authors: Sitzler, Paul
Warrier, Satish
Heriot, Alexander
Lee, Angus
Other Authors: Kong, J.
Zalcberg, J.
Keywords: Colorectal Cancer
Short-Term Outcomes
Emergency Presentation
Bi-National Colorectal Cancer Audit Database
Length of Stay
Complication Rate
Emergency Group
Elective Group
Logistic Regression Analysis
Independent Predictors for Inpatient Mortality
Predictive Model
Bootstrap Re-sampling Method
Surgical Complications
Medical Complications
Mortality Rate
Morbidity Rate
Tumour Stage
Postoperative Complications
Anastomotic Leak
American Society Anesthesiologists Score
General Surgery and Gastroenterology Clinical Institute, Epworth HealthCare, Victoria, Australia
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Sep-2018
Publisher: Springer
Citation: Int J Colorectal Dis. 2018 Sep 30.
Abstract: BACKGROUNDS: A significant number of patients with colorectal cancer will have an emergency presentation requiring surgery. This study aims to evaluate short-term outcomes for patients undergoing emergency colorectal cancer surgery in Australasia. METHODS: All consecutive CRC from the Bi-National Colorectal Cancer Audit Database was interrogated from 2007 to 2016. Short-term outcomes including length of stay, complication rate and mortality rate were compared between the emergency and elective groups. Logistic regression analysis was performed to identify independent predictors for inpatient mortality. A predictive model for inpatient mortality was constructed using these variables, and its accuracy was then validated by the Bootstrap re-sampling method. RESULTS: Of 15,676 colorectal cancer cases identified, 13.6% were emergency cases. The emergency group had a higher rate of surgical and medical complications (26.7% vs 22.6%, p < 0.001; 22.8 vs 13.8%, p < 0.001, respectively). Higher inpatient mortality rate was also observed in the emergency group (3.4% vs 2.6%, p = 0.023). Independent predictors for inpatient survival included age, American Society Anaesthesiologists score, emergency surgery and tumour stage. In addition, postoperative complications such as anastomotic leak (odds ratio [OR] 3.78, p < 0.001), sepsis (OR 2.85, p < 0.001) and medical complications (OR 13.88, p < 0.001) had a significant impact in survival in the emergency group. Receiver operating characteristics curve for inpatient mortality was 0.913. CONCLUSION: Emergency colorectal cancer surgery carries significant morbidity and mortality. Recognition of the increasing rate of postoperative complications may help minimise the detrimental impact of this event on overall outcomes.
DOI: 10.1007/s00384-018-3169-5
PubMed URL:
ISSN: 0179-1958
Journal Title: International Journal of Colorectal Disease
Type: Journal Article
Affiliated Organisations: Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
Cancer Research Program, School of Public Health & Preventive Medicine, Faculty of Medicine, Monash University, Monash, Melbourne, VIC, Australia.
Epworth Healthcare, Melbourne, VIC, Australia.
Type of Clinical Study or Trial: Audit
Appears in Collections:Cancer Services
General Surgery and Gastroenterology

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