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. 2020 Dec;22(12):1941-1948.
doi: 10.1111/codi.15238. Epub 2020 Aug 2.

Increased long-term mortality after emergency colon resections

M Fahim  1   2 , L M Dijksman  1 , P van der Nat  1   3 , W J M Derksen  2 , D H Biesma  1 , A B Smits  2
Affiliations

Increased long-term mortality after emergency colon resections

M Fahim et al. Colorectal Dis. 2020 Dec.

Abstract

Aim: Emergency surgery is a known predictor for 30-day mortality. However, its relationship with long-term mortality is still a matter of debate. The aim of this study was to analyse the effect of emergency surgery compared with elective surgery on long-term survival.

Method: Data from the Dutch Colorectal Audit and the Dutch Cancer Centre registry of a large nonacademic teaching hospital were used to analyse outcomes of patients who underwent surgery for colon cancer from 2009 until 2017. Univariable and multivariable Cox regression were used to assess the effect of emergency surgery on long-term mortality with adjustment for patient, tumour and treatment characteristics.

Results: A total of 1139 patients with a median follow-up of 40 months (interquartile range 23-65 months) were included. Emergency surgery was performed in 158 patients (14%). The 5-year survival after emergency surgery was 46% compared with 72% after elective surgery. After adjusting for baseline differences there was an independent and significant association between emergency surgery and increased long-term mortality (hazard ratio 1.79, 95% CI 1.28-2.51, P = 0.001).

Conclusion: Emergency surgery for colon cancer seems to lead to a significantly increased risk of long-term mortality compared with elective surgery. Detection and treatment of early symptoms that can lead to emergency surgery might be the way forward.

Keywords: Emergency surgery; colorectal cancer; long-term; mortality.

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References

    1. Ingraham AM, Cohen ME, Bilimoria KY et al. Comparison of hospital performance in nonemergency versus emergency colorectal operations at 142 hospitals. J Am Coll Surg 2010; 210: 155-65.
    1. Kolfschoten NE, Wouters MW, Gooiker GA et al. Nonelective colon cancer resections in elderly patients: results from the Dutch surgical colorectal audit. Dig Surg 2012; 29: 412-9.
    1. Sjo OH, Larsen S, Lunde OC, Nesbakken A. Short term outcome after emergency and elective surgery for colon cancer. Colorectal Dis 2009; 11: 733-9.
    1. Bakker IS, Snijders HS, Grossmann I, Karsten TM, Havenga K, Wiggers T. High mortality rates after nonelective colon cancer resection: results of a national audit. Colorectal Dis 2016; 18: 612-21.
    1. Amelung FJ, Consten ECJ, Siersema PD, Tanis PJ. A Population-based analysis of three treatment modalities for malignant obstruction of the proximal colon: acute resection versus stent or stoma as a bridge to surgery. Ann Surg Oncol 2016; 23: 3660-8.

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