[Risk factors in patients older than 70 years with complicated colorectal carcinoma]

Abstract

Objective: The aim of this study was to analyze the outcome of patients over 70 years of age who underwent emergency surgery for complicated colorectal carcinoma, as well as to identify the factors that might have some influence on outcome.

Patients and method: A retrospective study of 54 patients older than 70 years who underwent emergency surgery for complicated colorectal cancer (42 with obstruction and 12 with perforation) between 1991 and 2002 was performed. Morbidity and mortality after surgery were studied. To determine prognostic factors of morbidity and mortality a multivariate logistic regression analysis was also performed.

Results: Overall and major morbidity rates were 81.5% and 42.6%, respectively. The mortality rate was 27.8%. Multivariate analysis revealed that perioperative transfusion (p = 0.014) was an independent predictive factor of major complications and that a high APACHE II score (p = 0.031) and the presence of perforation proximal to the tumor (p = 0.042) independently predicted mortality.

Conclusions: Emergency surgery for complicated colorectal carcinoma in elderly patients carries elevated morbidity and mortality. The presence of risk factors should be taken into account when choosing the most suitable surgical technique and evaluating the need for intensive postoperative treatment.