Is colorectal surgery beyond the age of 80 still feasible with acceptable mortality? An analysis of the predictive value of CR-POSSUM and life expectancy after hospital discharge.
Colorectal Dis
; 19(1): 58-64, 2017 Jan.
Article
em En
| MEDLINE
| ID: mdl-27717124
ABSTRACT
AIM:
Increased morbidity and mortality could mitigate the positive effect of surgery in elderly patients undergoing colorectal resections. This retrospective study aims to describe early morbidity and mortality together with long-term survival in octogenarians and nonagenarians undergoing colorectal surgery. Predictors for in-hospital mortality are identified. The predictive value of CR-POSSUM is assessed.METHOD:
Data on consecutive patients 80 years old or more undergoing a colorectal resection in our centre from 2004 until 2010 were analysed.RESULTS:
Some 286 patients [median age 84 years; interquartile range (IQR) 81.6-86.1; 133 men, 47%] underwent a colorectal resection. Median follow-up was 32 months (IQR 14.5-51.2). Two hundred and fifty-eight patients (90%) were operated on for malignancy. Only 64 patients (22.4%) underwent a laparoscopic procedure. Overall median hospital stay was 12 days (IQR 9.0-20.0) and in-hospital mortality was 9.4%. Seventy-six per cent (n = 170) of patients could return home after discharge. The 1-year survival rate was 78.6% (95% CI 73.8-82.7). Median CR-POSSUM for in-hospital mortality was 12.6% (IQR 11.9-21.0). The concordance probability estimate was 0.668 (95% CI 0.609-0.728), reflecting a moderate predictive capacity of CR-POSSUM. Once patients had been discharged from hospital, life expectancy was similar to that of the Belgian general population.CONCLUSION:
Colorectal surgery in octogenarians and nonagenarians resulted in a considerable in-hospital mortality of about 9%. One-year mortality added an additional 12%, which is in concordance with the overall life expectancy at that age.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos do Sistema Digestório
/
Índice de Gravidade de Doença
/
Idoso de 80 Anos ou mais
/
Expectativa de Vida
/
Fatores Etários
/
Enteropatias
Tipo de estudo:
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article