Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr;93(4):926-931.
doi: 10.1111/ans.18091. Epub 2022 Oct 6.

Perioperative outcomes of emergency and elective colorectal surgery: a bi-institutional study

Alexander H Seeto  1   2 , Hajir Nabi  3 , Matthew J Burstow  2   3 , Raymond P Lancashire  1 , Joshua Grundy  1 , Christopher Gillespie  1 , Khuong Nguyen  1 , Sanjeev Naidu  1 , Terence C Chua  1   2   4
Affiliations

Perioperative outcomes of emergency and elective colorectal surgery: a bi-institutional study

Alexander H Seeto et al. ANZ J Surg. 2023 Apr.

Abstract

Background: Emergency colorectal surgery tends to be associated with poorer outcomes compared to elective colorectal surgery. This study assessed the morbidity and mortality in patients undergoing emergency and elective colorectal resection in two metropolitan hospitals.

Methods: Patients were identified retrospectively from two institutions between April 2018 and July 2020. Baseline, operative and postoperative parameters were collected for comparative analysis between emergency and elective surgery groups. A binary logistic regression was performed to identify independent predictors of postoperative complications.

Results: During the study period, 454 patients underwent colorectal resection, 135 were emergency cases (29.74%) and 319 were elective cases (70.26%). Compared with elective resections, patients undergoing emergency resections were observed to have a higher American Society of Anesthesiologists (ASA) score of III to IV (53.33% vs. 38.56%) (P = 0.004). The mortality rate was similar between the emergency and elective group (1.48% vs. 0.63%, P = 0.369). The overall complication rate was higher in patients undergoing emergency resections (64.44% vs. 36.68%, P < 0.001), but the major complication rate was similar between groups (12.59% vs. 10.34%, P = 0.484). Independent predictors for postoperative complications included emergency surgery (Odds Ratio (OR) 2.77, 95% Confidence Interval (CI): 1.66 to 4.61) and an ASA Score of III to IV (OR 2.87, 95% CI: 1.84 to 4.47).

Conclusion: The overall complication rate was higher in patients undergoing emergency colorectal resection, however, rates of major complications and mortality were similar between groups. Higher complication rates reflect advanced disease pathology in patients who are more comorbid.

Keywords: colectomy; colorectal surgery; emergency surgery; morbidity; mortality.

PubMed Disclaimer

References

    1. Ingraham AM, Cohen ME, Raval MV, Ko CY, Nathens AB. Comparison of hospital performance in emergency versus elective general surgery operations at 198 hospitals. J. Am. Coll. Surg. 2011; 212: 20-8.e1.
    1. Hernandez MC, Madbak F, Parikh K, Crandall M. GI surgical emergencies: scope and burden of disease. J. Gastrointest. Surg. 2019; 23: 827-36.
    1. Kim J, Mittal R, Konyalian V, King J, Stamos MJ, Kumar RR. Outcome analysis of patients undergoing colorectal resection for emergent and elective indications. Am. Surg. 2007; 73: 991-3.
    1. Havens JM, Peetz AB, Do WS et al. The excess morbidity and mortality of emergency general surgery. J. Trauma Acute Care Surg. 2015; 78: 306-11.
    1. Skala K, Gervaz P, Buchs N et al. Risk factors for mortality-morbidity after emergency-urgent colorectal surgery. Int. J. Color. Dis. 2009; 24: 311-6.

MeSH terms

LinkOut - more resources