Dr Pascal Gervaz

Chirurgien FMH, chirurgie interne & chirurgie viscérale

 

 

Risk Factors for Mortality-Morbidity After Emergency-urgent Colorectal Surgery

 

 

 

 

 

 

 

 

 

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

 

 

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 & 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).

 

Conclusion

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.


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in International journal of Colorectal Disease, 2009 Mar;24 (3):311-6. doi: 10.1007/ s00384-008-0603-0. Epub 2008 Oct 18.