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 |
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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 |
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