71223 - Risk factors for severe complications and mortality in elderly undergoing colon surgery – a retrospective cohort study from the ERAS-registry

Introduction The rising global population of older adults is expected to lead to more elderly individuals needing surgery for colon cancer. It's crucial to study risk factors for mortality and complications following colon surgery in this demographic. Method The Swedish part of the ERAS-database (EIAS) from 2009 and 2022 was used. Patients aged ≥ 75 years undergoing colon surgery were compared with younger patients regarding basic characteristics and type of surgery. Possible risk factors for mortality and complications in the elderly group were analyzed using multivariate regression. Result 11 767 patients were included. After adjusting for available confounders, male gender, OR: 1.62; 95% CI: (1.23-2.14), ASA ≥ 3, OR: 1.59; 95% CI: (1.19-2.12), severe pulmonary disease, OR: 1.74; 95% CI: (1.03-2.95), recent immunosuppressive treatment, OR: 3.23; 95% CI: (1.61-6.47), diverticular disease as indication for surgery, OR: 2.78; 95% CI: (1.53-5.07) and open surgery, OR: 1.40; 95% CI (1.05-1.85) were significantly associated with severe complications in patients ≥ 75 years. Likewise, smoking, OR: 2.59; 95% CI (1.04-6.50), ASA ≥ 3, OR: 2.38; 95% CI (1.15-4.92), severe pulmonary disease, OR: 2.98; 95% CI (1.21-7.33), and open surgery, OR: 2.07; 95% CI (1.09-3.91) were significantly associated with mortality within 30 days in the elderly group. Discussion Several risk factors for severe complications and mortality within 30 days of colon surgery in the elderly population were identified. Among these, severe pulmonary disease, an ASA score of ≥ 3, and undergoing open surgery were all significantly associated with both severe complications and mortality.