Colorectal resection and primary anastomosis in patients aged 70 and older: prospective study

Abstract

Objective: To assess the differences in morbidity, mortality, and other immediate postoperative results of colorectal resection with primary anastomosis in relation to age.

Design: Prospective study.

Setting: District hospital, Spain.

Subjects: 316 consecutive patients who required colorectal resection with primary anastomosis between 1991 and 1995, 155 of whom were aged <70 years and 161 who were 70 years or more.

Main outcome measures: Mortality, morbidity, and hospital stay.

Results: 116 patients aged <70 (75%) were American Society of Anaesthesiologists (ASA) grades I-II compared with 82 (51%) aged > or =70.33 of the younger patients (21%) and 49 of the older (30%) developed complications. The anastomotic leak rate was 14% (n = 21) in the younger group and 16% (n = 26) among those aged > or =70. Median hospital stay was 14 and 15 days, respectively (ranges 8-81 and 1-120). 4 died (3%) among those aged <70 compared with 17 (11%) in the older group (p = 0.009, chi square 6.9). Mortality for elective resections was 6% (15/263) compared with 11% (6/53) for emergencies. There were no significant differences in mortality according to ASA grade between age groups.

Conclusions: People aged 70 or more are not a high risk group for colorectal resection and primary anastomosis as a result of their age alone. Mortality and morbidity depend more on ASA grade and whether the operation was elective or emergency.