The impact of comorbidities on post-operative complications following colorectal cancer surgery

Autor: Diana P L Tam, Ian M Shaw, Harish Iswariah, Robert Franz, Stephanie T. Yerkovich, Manju D. Chandrasegaram, Derek Mao, Andrew Hughes, David E Flynn
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Pulmonology
Colorectal cancer
Cancer Treatment
Comorbidity
Postoperative Complications
0302 clinical medicine
Atrial Fibrillation
Medicine and Health Sciences
Medicine
030212 general & internal medicine
Digestive System Surgical Procedures
Aged
80 and over
COPD
education.field_of_study
Univariate analysis
Multidisciplinary
Atrial fibrillation
Middle Aged
Tumor Resection
Surgical Oncology
Oncology
030220 oncology & carcinogenesis
Female
Colorectal Neoplasms
Arrhythmia
Research Article
Clinical Oncology
medicine.medical_specialty
Heart Diseases
Chronic Obstructive Pulmonary Disease
Science
Population
Cardiology
Surgical and Invasive Medical Procedures
03 medical and health sciences
Internal medicine
Humans
education
Aged
Colorectal Cancer
Surgical Resection
business.industry
Cancers and Neoplasms
Retrospective cohort study
medicine.disease
Laparoscopy
Clinical Medicine
business
Complication
Zdroj: PLoS ONE, Vol 15, Iss 12, p e0243995 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: Background Colorectal cancer surgery is complex and can result in severe post-operative complications. Optimisation of surgical outcomes requires a thorough understanding of the background complexity and comorbid status of patients. Aim The aim of this study is to determine whether certain pre-existing comorbidities are associated with high grade post-operative complications following colorectal cancer surgery. The study also aims to define the prevalence of demographic, comorbid and surgical features in a population undergoing colorectal cancer resection. Method A colorectal cancer database at The Prince Charles Hospital was established to capture detailed information on patient background, comorbidities and clinicopathological features. A single-centre retrospective study was undertaken to assess the effect of comorbidities on post-operative outcomes following colorectal cancer resection. Five hundred and thirty-three patients were reviewed between 2010–2018 to assess if specific comorbidities were associated with higher grade post-operative complications. A Clavien-Dindo grade of three or higher was defined as a high grade complication. Results Fifty-eight percent of all patients had an ASA grade of ASA III or above. The average BMI of patients undergoing resection was 28 ± 6.0. Sixteen percent of all patients experienced a high grade complications. Patients with high grade complications had a higher mean average age compared to patients with low grade or no post-operative complications (74 years vs 70 years, p = 0.01). Univariate analysis revealed patients with atrial fibrillation, COPD, ischaemic heart disease and heart failure had an increased risk of high grade complications. Multivariate analysis revealed pre-existing atrial fibrillation (OR 2.70, 95% CI 1.53–4.89, p Conclusion Pre-existing atrial fibrillation and COPD are independent risk factors for high grade complications. Targeted perioperative management is necessary to optimise outcomes.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje