BACKGROUND: The aim of this study was to identify risk factors in emergency surgery for colonic cancer in a large population and to investigate the economic impact of such surgery. METHODS: Data from the colonic cancer registry (1997-2001) of the Uppsala/Orebro Regional Oncological Centre were analysed and classified by hospital category. Some 3259 patients were included; 806 had an emergency and 2453 an elective procedure. Data for calculating effects on health economy were derived from a national case-costing register. RESULTS: Patients who had emergency surgery had more advanced tumours and a lower survival rate than those who had an elective procedure (5-year survival rate 29.8 versus 52.4 per cent; P < 0.001). There was a stage-specific difference in survival, with poorer survival both for patients with stage I and II tumours and for those with stage III tumours after emergency compared with elective surgery (P < 0.001). Emergency surgery was associated with a longer hospital stay (mean 18.0 versus 10.0 days; P < 0.001) and higher costs (relative cost 1.5 (95 per cent confidence interval 1.4 to 1.6)) compared with elective surgery. The duration of hospital stay was the strongest determinant of cost (r(2) = 0.52, P < 0.001). CONCLUSION: Emergency surgery for colonic cancer is associated with a stage-specific increase in mortality rate.
BACKGROUND: The aim of this study was to identify risk factors in emergency surgery for colonic cancer in a large population and to investigate the economic impact of such surgery. METHODS: Data from the colonic cancer registry (1997-2001) of the Uppsala/Orebro Regional Oncological Centre were analysed and classified by hospital category. Some 3259 patients were included; 806 had an emergency and 2453 an elective procedure. Data for calculating effects on health economy were derived from a national case-costing register. RESULTS:Patients who had emergency surgery had more advanced tumours and a lower survival rate than those who had an elective procedure (5-year survival rate 29.8 versus 52.4 per cent; P < 0.001). There was a stage-specific difference in survival, with poorer survival both for patients with stage I and II tumours and for those with stage III tumours after emergency compared with elective surgery (P < 0.001). Emergency surgery was associated with a longer hospital stay (mean 18.0 versus 10.0 days; P < 0.001) and higher costs (relative cost 1.5 (95 per cent confidence interval 1.4 to 1.6)) compared with elective surgery. The duration of hospital stay was the strongest determinant of cost (r(2) = 0.52, P < 0.001). CONCLUSION: Emergency surgery for colonic cancer is associated with a stage-specific increase in mortality rate.
Authors: Samer Tohme; Daniel Sukato; Gary W Nace; Albert Zajko; Nikhil Amesur; Philip Orons; Didier Chalhoub; James W Marsh; David A Geller; Allan Tsung Journal: HPB (Oxford) Date: 2014-08-15 Impact factor: 3.647
Authors: Martin Janson; Gunnar Edlund; Ulf Kressner; Elisabet Lindholm; Lars Påhlman; Stefan Skullman; Bo Anderberg; Eva Haglind Journal: Surg Endosc Date: 2008-12-05 Impact factor: 4.584
Authors: Fausto Catena; Luca Ansaloni; Andrea Avanzolini; Salomone Di Saverio; Luigi D'Alessandro; Mario Maldini Casadei; Antonio Pinna Journal: Int J Colorectal Dis Date: 2009-03-13 Impact factor: 2.571
Authors: Augustine C Obirieze; Mehreen Kisat; Caitlin W Hicks; Tolulope A Oyetunji; Eric B Schneider; Darrell J Gaskin; Elliott R Haut; David T Efron; Edward E Cornwell; Adil H Haider Journal: J Trauma Acute Care Surg Date: 2013-05 Impact factor: 3.313