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Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes
There has been an increase in surgical interventions in frailer elderly with concomitant chronic diseases. The purpose of this paper was to evaluate the impact of aging and comorbidities on outcomes in patients who underwent surgery for the treatment of colorectal cancer (CRC) in Veneto Region (Nort...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995267/ https://www.ncbi.nlm.nih.gov/pubmed/34115323 http://dx.doi.org/10.1007/s13304-021-01086-4 |
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author | Basso, Cristina Gennaro, Nicola Dotto, Matilde Ferroni, Eliana Noale, Marianna Avossa, Francesco Schievano, Elena Aceto, Paola Tommasino, Concezione Crucitti, Antonio Incalzi, Raffaele Antonelli Volpato, Stefano Petrini, Flavia Carron, Michele Pace, Maria Caterina Bettelli, Gabriella Chiumiento, Fernando Corcione, Antonio Montorsi, Marco Trabucchi, Marco Maggi, Stefania Corti, Maria Chiara |
author_facet | Basso, Cristina Gennaro, Nicola Dotto, Matilde Ferroni, Eliana Noale, Marianna Avossa, Francesco Schievano, Elena Aceto, Paola Tommasino, Concezione Crucitti, Antonio Incalzi, Raffaele Antonelli Volpato, Stefano Petrini, Flavia Carron, Michele Pace, Maria Caterina Bettelli, Gabriella Chiumiento, Fernando Corcione, Antonio Montorsi, Marco Trabucchi, Marco Maggi, Stefania Corti, Maria Chiara |
author_sort | Basso, Cristina |
collection | PubMed |
description | There has been an increase in surgical interventions in frailer elderly with concomitant chronic diseases. The purpose of this paper was to evaluate the impact of aging and comorbidities on outcomes in patients who underwent surgery for the treatment of colorectal cancer (CRC) in Veneto Region (Northeastern Italy). This is a retrospective cohort study in patients ≥ 40 years who underwent elective or urgent CRC surgical resection between January 2013 and December 2015. Independent variables included: age, sex, and comorbidities. We analyzed variables associated with the surgical procedure, such as stoma creation, hospitalization during the year before the index surgery, the surgical approach used, the American Society of Anesthesiologists (ASA) score, and the Charlson Comorbidity Index score. Eight thousand four hundred and forty-seven patients with CRC underwent surgical resection. Patient age affected both pre- and post-resection LOS as well as the overall survival (OS); however, it did not affect the 30-day readmission and reoperation rates. Multivariate analysis showed that age represented a risk factor for longer preoperative and postoperative LOS as well as for 30-day and 365-day mortality, but it was not associated with an increased risk of 30-day reoperation and 30-day readmission. Chronic Heart Failure increased the 30-day mortality risk by four times, the preoperative LOS by 51%, and the postoperative LOS by 33%. Chronic renal failure was associated with a 74% higher 30-day readmission rate. Advanced age and comorbidities require a careful preoperative evaluation and appropriate perioperative management to improve surgical outcomes in older patients undergoing elective or urgent CRC resection. |
format | Online Article Text |
id | pubmed-8995267 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-89952672022-04-27 Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes Basso, Cristina Gennaro, Nicola Dotto, Matilde Ferroni, Eliana Noale, Marianna Avossa, Francesco Schievano, Elena Aceto, Paola Tommasino, Concezione Crucitti, Antonio Incalzi, Raffaele Antonelli Volpato, Stefano Petrini, Flavia Carron, Michele Pace, Maria Caterina Bettelli, Gabriella Chiumiento, Fernando Corcione, Antonio Montorsi, Marco Trabucchi, Marco Maggi, Stefania Corti, Maria Chiara Updates Surg Original Article There has been an increase in surgical interventions in frailer elderly with concomitant chronic diseases. The purpose of this paper was to evaluate the impact of aging and comorbidities on outcomes in patients who underwent surgery for the treatment of colorectal cancer (CRC) in Veneto Region (Northeastern Italy). This is a retrospective cohort study in patients ≥ 40 years who underwent elective or urgent CRC surgical resection between January 2013 and December 2015. Independent variables included: age, sex, and comorbidities. We analyzed variables associated with the surgical procedure, such as stoma creation, hospitalization during the year before the index surgery, the surgical approach used, the American Society of Anesthesiologists (ASA) score, and the Charlson Comorbidity Index score. Eight thousand four hundred and forty-seven patients with CRC underwent surgical resection. Patient age affected both pre- and post-resection LOS as well as the overall survival (OS); however, it did not affect the 30-day readmission and reoperation rates. Multivariate analysis showed that age represented a risk factor for longer preoperative and postoperative LOS as well as for 30-day and 365-day mortality, but it was not associated with an increased risk of 30-day reoperation and 30-day readmission. Chronic Heart Failure increased the 30-day mortality risk by four times, the preoperative LOS by 51%, and the postoperative LOS by 33%. Chronic renal failure was associated with a 74% higher 30-day readmission rate. Advanced age and comorbidities require a careful preoperative evaluation and appropriate perioperative management to improve surgical outcomes in older patients undergoing elective or urgent CRC resection. Springer International Publishing 2021-06-11 2022 /pmc/articles/PMC8995267/ /pubmed/34115323 http://dx.doi.org/10.1007/s13304-021-01086-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Basso, Cristina Gennaro, Nicola Dotto, Matilde Ferroni, Eliana Noale, Marianna Avossa, Francesco Schievano, Elena Aceto, Paola Tommasino, Concezione Crucitti, Antonio Incalzi, Raffaele Antonelli Volpato, Stefano Petrini, Flavia Carron, Michele Pace, Maria Caterina Bettelli, Gabriella Chiumiento, Fernando Corcione, Antonio Montorsi, Marco Trabucchi, Marco Maggi, Stefania Corti, Maria Chiara Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes |
title | Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes |
title_full | Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes |
title_fullStr | Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes |
title_full_unstemmed | Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes |
title_short | Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes |
title_sort | congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995267/ https://www.ncbi.nlm.nih.gov/pubmed/34115323 http://dx.doi.org/10.1007/s13304-021-01086-4 |
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