Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes
| Autor: | Stefano Volpato, Marco Trabucchi, Matilde Dotto, Maria Chiara Corti, Flavia Petrini, Stefania Maggi, Francesco Avossa, Michele Carron, Antonio Corcione, Concezione Tommasino, Marianna Noale, Raffaele Antonelli Incalzi, Cristina Basso, Maria Caterina Pace, Gabriella Bettelli, Paola Aceto, Eliana Ferroni, Antonio Crucitti, Nicola Gennaro, Marco Montorsi, Elena Schievano, Fernando Chiumiento |
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| Přispěvatelé: | 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 |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis ACG Age Colorectal cancer surgery Comorbidities LOS Perioperative outcomes Colorectal cancer Comorbidity 030230 surgery Patient Readmission NO 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors Medicine Humans Risk factor Aged Retrospective Studies Heart Failure business.industry Retrospective cohort study Perioperative Length of Stay medicine.disease Surgery 030220 oncology & carcinogenesis Heart failure Concomitant Comorbiditie Colorectal Neoplasms business |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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