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Burden of Emergency and Non-emergency Colorectal Cancer Surgeries in West Virginia and the USA

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Abstract

Purpose

Elective surgical resection is the curative treatment for colorectal cancer (CRC). Up to 30 % of patients present as surgical emergencies. The objective was to determine the association between presenting with an emergency condition and consequent outcomes of CRC surgery in the Appalachian state of West Virginia (WV) in comparison to the rest of the USA.

Methods

Patients diagnosed with CRC who underwent a surgical procedure from January 1, 2003 to December 31, 2007 were selected, and those with a diagnosis requiring emergency surgery were identified. Primary outcome measures were length of stay (LOS), total hospital charges, and inpatient death.

Results

Mean LOS was higher for WV. Mean charges were higher for the USA than for WV. Inpatient deaths in WV were greater than the rest of the USA. Those undergoing emergency surgery spent 51.9 % (β = 0.40) more days in the hospital than those who did not. For WV, LOS was 7.6 % (β = 0.07) higher than that of the US. Hospital charges for those that underwent emergency resection were 68.3 % (β = 0.52) higher than those who did not. The odds of in-hospital death were 1.68 (95 % CI = 1.42–1.98) times greater in WV than in the USA. Those that underwent emergency surgery had a nearly four times (OR 3.88; 95 % CI = 3.74–4.03) greater chance of in-hospital death.

Conclusions

The study stresses the ongoing burden of emergency surgeries in many states around the nation and the need to increase awareness about CRC screening practices, especially in patients who are at increased risk of the disease.

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Acknowledgments

The primary author was supported by a grant (1R24HS018622-01 PI: S. Madhavan) from the Agency of Healthcare Research and Quality during the conduct of this study.

Disclosure

The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. The authors claim no conflicts of interest. At the time the study was conducted, manuscript written, and sent for initial review, Neel A. Shah was a graduate student and PhD candidate at West Virginia University, School of Pharmacy, Morgantown, WV. At the time of acceptance and publication, Neel A. Shah was an employee of Amgen, Inc., Thousand Oaks, CA.

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Authors and Affiliations

  1. Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, 26506-9510, USA

    Neel A. Shah, Joel Halverson & Suresh Madhavan

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  1. Neel A. Shah
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  2. Joel Halverson
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  3. Suresh Madhavan
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Correspondence to Neel A. Shah.

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Shah, N.A., Halverson, J. & Madhavan, S. Burden of Emergency and Non-emergency Colorectal Cancer Surgeries in West Virginia and the USA. J Gastrointest Canc 44, 46–53 (2013). https://doi.org/10.1007/s12029-012-9455-5

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  • DOI: https://doi.org/10.1007/s12029-012-9455-5

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