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June 17, 2012Diseases of the Colon & Rectum

Poor 1-Year Survival in Elderly Patients Undergoing Nonelective Colorectal Resection

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Key result

Nonelective colorectal resection in patients ≥70 years was associated with high 30-day mortality that increased with age (17.0% to 31.0%; p<0.001), reaching 51.2% at 1 year for patients >80 years.

Population

36,767 patients aged ≥ 70 years who underwent a nonelective colorectal resection in an English National…

Design

Cohort

Follow-up

1 year

Authors

RMRavikrishna MamidannaLewisham and Greenwich NHS TrustLELola Eid-ArimokuAAAlex M. AlmoudarisUniversity College London

Discussion

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Implication

High mortality after nonelective colorectal resection in patients ≥70 years warrants caution in decisions; leaves open prospective studies on selection and alternatives.

Study Design

Type

Observational (n=36,767)

Multicenter

Yes

Structured PICO

P
Population
36,767 patients aged ≥70 years undergoing nonelective colorectal resection in England, followed for up to 1 year.
E
Exposure
Nonelective colorectal resection
O
Outcome
30-day in hospital mortality, 365-day mortality, unplanned readmission within 28 days of discharge, and duration of hospital stayhard clinical

Main Result

p-value: p=<0.001

Nonelective colorectal resection in elderly patients, particularly those over 80 years old, is associated with exceptionally high mortality, with over half dying within one year of surgery.

Limitations

  • Retrospective analysis of a prospective database
  • Stage of disease at presentation, severity of complications, and cause of death cannot be ascertained from this database
  • Stage of disease at presentation cannot be ascertained
  • Severity of complications cannot be ascertained
  • Cause of death cannot be ascertained

Cite This Study

Mamidanna et al. (2012) conducted an observational in Nonelective colorectal resection (n=36,767). Nonelective colorectal resection was evaluated on 30-day in hospital mortality, 365-day mortality, unplanned readmission within 28 days of discharge, and duration of hospital stay (p=<0.001). Nonelective colorectal resection in patients ≥70 years was associated with high 30-day mortality that increased with age (17.0% to 31.0%; p<0.001), reaching 51.2% at 1 year for patients >80 years.

synapsesocial.com/papers/6aa224369381edd5a407eda9https://doi.org/10.1097/dcr.0b013e3182585a35
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Operative Risk Factors of Colon Resection in the Elderly1980 · 141 citations
  2. 2Colorectal cancer in nonagenarians2011 · 38 citations
  3. 3Emergency resection and primary anastomosis for left-sided obstructing colorectal carcinoma in the elderly1998 · 94 citations
  4. 4Use of administrative data or clinical databases as predictors of risk of death in hospital: comparison of models2007 · 305 citations
  5. 5Secular changes in colorectal cancer incidence by subsite, stage at diagnosis, and race/ethnicity, 1992–20012006 · 171 citations