Thea Helene Degett1,2, Susanne Oksbjerg Dalton3, Jane Christensen4, Jes Søgaard4,5, Lene Hjerrild Iversen6,7, Ismail Gögenur8,7. 1. Documentation and Quality Department, Danish Cancer Society, Copenhagen, Denmark. theadegett@gmail.com. 2. Centre for Surgical Science (CSS), Zealand University Hospital, Lykkebækvej 1, 4600, Køge, Denmark. theadegett@gmail.com. 3. Unit of Survivorship, Danish Cancer Society Research Centre, Copenhagen, Denmark. 4. Documentation and Quality Department, Danish Cancer Society, Copenhagen, Denmark. 5. Institute of Clinical Medicine, University of Southern Denmark, Odense, Denmark. 6. Department of Surgery, Section of Coloproctology, Aarhus University Hospital, Aarhus, Denmark. 7. Danish Colorectal Cancer Group, Copenhagen, Denmark. 8. Centre for Surgical Science (CSS), Zealand University Hospital, Lykkebækvej 1, 4600, Køge, Denmark.
Abstract
PURPOSE: The aim of this study was to investigate if postoperative mortality after acute surgical treatment of colorectal cancer has decreased in Denmark during this period and to investigate risk factors associated with early death. METHODS: This is a nationwide and population-based cohort study. From the Danish Colorectal Cancer Group database and National Patient Registry, we collected data on all patients operated with bowel resection, diverting stoma only, or placement of an endoscopic stent from 2005 to 2015. Year of surgery was the main exposure variable and 90-day postoperative mortality the primary outcome. RESULTS: We included 6147 patients. The incidence of patients per year was stable during 2005-2015. The 90-day mortality decreased from 31% in 2005 to 24% in 2015 with a significant time trend (p < 0.0001). Other factors associated with postoperative mortality were increasing age, presence of comorbidity (measured as Charlson comorbidity index score ≥ 1), and stage IV disease. Insertion of self-expanding metallic stent was protective for 90-day postoperative mortality compared with other surgical procedures. CONCLUSION: Ninety-day postoperative mortality from acute colorectal surgery has improved in Denmark from 2005 to 2015. Nevertheless, almost one out of four patients undergoing acute surgery for colorectal cancer dies within 90 days.
PURPOSE: The aim of this study was to investigate if postoperative mortality after acute surgical treatment of colorectal cancer has decreased in Denmark during this period and to investigate risk factors associated with early death. METHODS: This is a nationwide and population-based cohort study. From the Danish Colorectal Cancer Group database and National Patient Registry, we collected data on all patients operated with bowel resection, diverting stoma only, or placement of an endoscopic stent from 2005 to 2015. Year of surgery was the main exposure variable and 90-day postoperative mortality the primary outcome. RESULTS: We included 6147 patients. The incidence of patients per year was stable during 2005-2015. The 90-day mortality decreased from 31% in 2005 to 24% in 2015 with a significant time trend (p < 0.0001). Other factors associated with postoperative mortality were increasing age, presence of comorbidity (measured as Charlson comorbidity index score ≥ 1), and stage IV disease. Insertion of self-expanding metallic stent was protective for 90-day postoperative mortality compared with other surgical procedures. CONCLUSION: Ninety-day postoperative mortality from acute colorectal surgery has improved in Denmark from 2005 to 2015. Nevertheless, almost one out of four patients undergoing acute surgery for colorectal cancer dies within 90 days.
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