Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians

Young Wan Kim, Ik Yong Kim Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea Purpose: To identify the factors affecting 30-day postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and no...

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Autores principales:	Kim YW, Kim IY
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Colonic neoplasms rectal neoplasms laparoscopy laparotomy aged 80 and over Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/10b995da21884f95a250f04518d4f7b8
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spelling	oai:doaj.org-article:10b995da21884f95a250f04518d4f7b82021-12-02T00:36:04ZFactors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians1178-1998https://doaj.org/article/10b995da21884f95a250f04518d4f7b82016-05-01T00:00:00Zhttps://www.dovepress.com/factors-associated-with-postoperative-complications-and-1-year-mortali-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Young Wan Kim, Ik Yong Kim Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea Purpose: To identify the factors affecting 30-day postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians. Methods: Between 2005 and 2014, a total of 204 consecutive patients aged ≥80 years who underwent major colorectal surgery were included. Results: One hundred patients were male (49%) and 52 patients had American Society of Anesthesiologists (ASA) score ≥3 (25%). Combined surgery was performed in 32 patients (16%). Postoperative complications within 30 days after surgery occurred in 54 patients (26%) and 30-day mortality occurred in five patients (2%). Independent risk factors affecting 30-day postoperative complications were older age (≥90 years, hazard ratio [HR] with 95% confidence interval [CI] =4.95 [1.69-14.47], P=0.004), an ASA score ≥3 (HR with 95% CI =4.19 [1.8-9.74], P=0.001), performance of combined surgery (HR with 95% CI =3.1 [1.13-8.46], P=0.028), lower hemoglobin level (<10 g/dL, HR with 95% CI =7.56 [3.07-18.63], P<0.001), and lower albumin level (<3.4 g/dL, HR with 95% CI =3.72 [1.43-9.69], P=0.007). An ASA score ≥3 (HR with 95% CI =2.72 [1.15-6.46], P=0.023), tumor-node-metastasis (TNM) stage IV (HR with 95% CI =3.47 [1.44-8.39], P=0.006), and occurrence of postoperative complications (HR with 95% CI =4.42 [1.39-14.09], P=0.012) were significant prognostic factors for 1-year mortality. Conclusion: Patient-related factors (older age, higher ASA score, presence of anemia, and lower serum albumin) and procedure-related factors (performance of combined surgical procedure) increased postoperative complications. Avoidance of 30-day postoperative complications may decrease 1-year mortality. Keywords: colonic neoplasms, rectal neoplasms, laparoscopy, laparotomy, aged 80 years and aboveKim YWKim IYDove Medical PressarticleColonic neoplasmsrectal neoplasmslaparoscopylaparotomyaged 80 and overGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 689-697 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Colonic neoplasms rectal neoplasms laparoscopy laparotomy aged 80 and over Geriatrics RC952-954.6
spellingShingle	Colonic neoplasms rectal neoplasms laparoscopy laparotomy aged 80 and over Geriatrics RC952-954.6 Kim YW Kim IY Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians
description	Young Wan Kim, Ik Yong Kim Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea Purpose: To identify the factors affecting 30-day postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians. Methods: Between 2005 and 2014, a total of 204 consecutive patients aged ≥80 years who underwent major colorectal surgery were included. Results: One hundred patients were male (49%) and 52 patients had American Society of Anesthesiologists (ASA) score ≥3 (25%). Combined surgery was performed in 32 patients (16%). Postoperative complications within 30 days after surgery occurred in 54 patients (26%) and 30-day mortality occurred in five patients (2%). Independent risk factors affecting 30-day postoperative complications were older age (≥90 years, hazard ratio [HR] with 95% confidence interval [CI] =4.95 [1.69-14.47], P=0.004), an ASA score ≥3 (HR with 95% CI =4.19 [1.8-9.74], P=0.001), performance of combined surgery (HR with 95% CI =3.1 [1.13-8.46], P=0.028), lower hemoglobin level (<10 g/dL, HR with 95% CI =7.56 [3.07-18.63], P<0.001), and lower albumin level (<3.4 g/dL, HR with 95% CI =3.72 [1.43-9.69], P=0.007). An ASA score ≥3 (HR with 95% CI =2.72 [1.15-6.46], P=0.023), tumor-node-metastasis (TNM) stage IV (HR with 95% CI =3.47 [1.44-8.39], P=0.006), and occurrence of postoperative complications (HR with 95% CI =4.42 [1.39-14.09], P=0.012) were significant prognostic factors for 1-year mortality. Conclusion: Patient-related factors (older age, higher ASA score, presence of anemia, and lower serum albumin) and procedure-related factors (performance of combined surgical procedure) increased postoperative complications. Avoidance of 30-day postoperative complications may decrease 1-year mortality. Keywords: colonic neoplasms, rectal neoplasms, laparoscopy, laparotomy, aged 80 years and above
format	article
author	Kim YW Kim IY
author_facet	Kim YW Kim IY
author_sort	Kim YW
title	Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians
title_short	Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians
title_full	Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians
title_fullStr	Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians
title_full_unstemmed	Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians
title_sort	factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/10b995da21884f95a250f04518d4f7b8
work_keys_str_mv	AT kimyw factorsassociatedwithpostoperativecomplicationsand1yearmortalityaftersurgeryforcolorectalcancerinoctogenariansandnonagenarians AT kimiy factorsassociatedwithpostoperativecomplicationsand1yearmortalityaftersurgeryforcolorectalcancerinoctogenariansandnonagenarians
_version_	1718403598880079872

Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians

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