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Short-term outcome of emergency colorectal cancer surgery: results from Bi-National Colorectal Cancer Audit

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International Journal of Colorectal Disease Aims and scope Submit manuscript

A Correction to this article was published on 14 November 2018

This article has been updated

Abstract

Backgrounds

A significant number of patients with colorectal cancer will have an emergency presentation requiring surgery. This study aims to evaluate short-term outcomes for patients undergoing emergency colorectal cancer surgery in Australasia.

Methods

All consecutive CRC from the Bi-National Colorectal Cancer Audit Database was interrogated from 2007 to 2016. Short-term outcomes including length of stay, complication rate and mortality rate were compared between the emergency and elective groups. Logistic regression analysis was performed to identify independent predictors for inpatient mortality. A predictive model for inpatient mortality was constructed using these variables, and its accuracy was then validated by the Bootstrap re-sampling method.

Results

Of 15,676 colorectal cancer cases identified, 13.6% were emergency cases. The emergency group had a higher rate of surgical and medical complications (26.7% vs 22.6%, p < 0.001; 22.8 vs 13.8%, p < 0.001, respectively). Higher inpatient mortality rate was also observed in the emergency group (3.4% vs 2.6%, p = 0.023). Independent predictors for inpatient survival included age, American Society Anaesthesiologists score, emergency surgery and tumour stage. In addition, postoperative complications such as anastomotic leak (odds ratio [OR] 3.78, p < 0.001), sepsis (OR 2.85, p < 0.001) and medical complications (OR 13.88, p < 0.001) had a significant impact in survival in the emergency group. Receiver operating characteristics curve for inpatient mortality was 0.913.

Conclusion

Emergency colorectal cancer surgery carries significant morbidity and mortality. Recognition of the increasing rate of postoperative complications may help minimise the detrimental impact of this event on overall outcomes.

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Change history

  • 14 November 2018

    The publisher regret that a typographical error was present in the Table 1 of the original version of this article. The value “20,032” should have been “2” in the Variable column under T stage. The correct table is now presented correctly in this article.

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Acknowledgements

We would like to acknowledge and thank the Bi-National Colorectal Cancer Audit and all the surgeons who contribute to the audit, without whom this study would not be possible. We thank Epworth Healthcare for all the support and assistance.

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Authors and Affiliations

  1. Epworth Healthcare, Melbourne, VIC, 3121, Australia

    Chun Hin Angus Lee, Alexander G. Heriot, Satish Warrier & Paul Sitzler

  2. Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia

    Chun Hin Angus Lee, Joseph Cherng Huei Kong, Alexander G. Heriot & Satish Warrier

  3. Cancer Research Program, School of Public Health & Preventive Medicine, Faculty of Medicine, Monash University, Monash, Melbourne, VIC, 3004, Australia

    John Zalcberg

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  1. Chun Hin Angus Lee
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  2. Joseph Cherng Huei Kong
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  3. Alexander G. Heriot
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Correspondence to Chun Hin Angus Lee.

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The authors declare that they have no conflict of interest.

Additional information

The original version of this article was revised: A typographical error was present in the Table 1 of the original version of this article. The value “20,032” should have been “2” in the Variable column under T stage. The table has been corrected.

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Lee, C.H.A., Kong, J.C.H., Heriot, A.G. et al. Short-term outcome of emergency colorectal cancer surgery: results from Bi-National Colorectal Cancer Audit. Int J Colorectal Dis 34, 63–69 (2019). https://doi.org/10.1007/s00384-018-3169-5

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  • DOI: https://doi.org/10.1007/s00384-018-3169-5

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