International Journal of Colorectal Disease

, Volume 28, Issue 7, pp 941–947

Curative colorectal resections in patients aged 80 years and older: clinical characteristics, morbidity, mortality and risk factors

  • Ugochukwu Ihedioha
  • Gianpiero Gravante
  • Geraint Lloyd
  • Sam Sangal
  • Roberto Sorge
  • Baljit Singh
  • Sanjay Chaudhri
Original Article

DOI: 10.1007/s00384-012-1626-0

Cite this article as:
Ihedioha, U., Gravante, G., Lloyd, G. et al. Int J Colorectal Dis (2013) 28: 941. doi:10.1007/s00384-012-1626-0

Abstract

Background

The management of colorectal cancer in the elderly presents unique challenges. The objective of this study was to determine outcomes following curative colorectal resection in patients aged 80 years and older.

Patients and methods

Study design is retrospective. Data were extracted from the university hospital database and medical records of patients aged 80 years and older operated between April 2004 and December 2009. Intervention was curative colorectal resection. Main outcome measures include postoperative morbidity, mortality and individual risk factors associated with them.

Results

Three hundred fifty-eight patients (43.8 % males, age = 84 ± 3 years) were included; 72.6 % received elective surgery. A significantly higher complication rate and 30 day, 1 year and 4 year mortality were present for emergency operations compared to elective (p < 0.001). One-year survival was 65.0 % for elective resections and 55.1 % for emergency. At 4 years of follow-up, survival was 49.2 % for the elective vs. 27.6 % for emergency. The American Society of Anesthesiologists (ASA) score is the only factor associated with the 30-day mortality at the multivariate analysis (p < 0.01), Dukes staging with overall mortality (p < 0.005), sex and mode of the operation with major complications (p < 0.05). A limitation of the study is that is retrospective.

Conclusions

The highest mortality rates following colorectal surgery in the elderly are in the early postoperative period, especially for emergency operations and patients with significant comorbidities. However, the 1-year survival following elective curative resection for colorectal cancer approaches 65 %. ASA score and modality of the operation (elective vs. emergency) impacted on postoperative mortality and morbidity and could be used to select patients with more favourable outcomes.

Keywords

Colorectal surgery Age Morbidity Mortality 

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Ugochukwu Ihedioha
    • 1
  • Gianpiero Gravante
    • 2
  • Geraint Lloyd
    • 1
  • Sam Sangal
    • 1
  • Roberto Sorge
    • 3
  • Baljit Singh
    • 1
  • Sanjay Chaudhri
    • 1
  1. 1.Department of Colorectal SurgeryUniversity Hospitals of LeicesterLeicesterUK
  2. 2.Department of Colorectal SurgeryPilgrim HospitalBoston, LincolnshireUK
  3. 3.Department of Human Physiology, Laboratory of BiometryUniversity of Tor VergataRomeItaly

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