Marisa Baré1, Laura Mora2, Miguel Pera3, Pablo Collera4, Maximino Redondo5, Antonio Escobar6, Rocío Anula7, José María Quintana8. 1. Clinical Epidemiology and Cancer Screening, Parc Taulí University Hospital, Universitat Autònoma de Barcelona, Sabadell, Spain; Health Services Research on Chronic Diseases Network (REDISSEC), Spain. Electronic address: mbare@tauli.cat. 2. General and Digestive Surgery Department, Parc Taulí University Hospital, Sabadell, Spain. 3. General and Digestive Surgery Department, Parc de Salut Mar, Barcelona, Spain. 4. General and Digestive Surgery Department, Althaia-Xarxa Assistencial Universitaria, Manresa, Spain. 5. Research Unit, Hospital Costa del Sol, University of Málaga, Marbella, Spain; Health Services Research on Chronic Diseases Network (REDISSEC), Spain. 6. Research Unit, Hospital Universitario Basurto, Bilbao, Spain; Health Services Research on Chronic Diseases Network (REDISSEC), Spain. 7. General and Digestive Surgery Department, Hospital Universitario Clínico San Carlos, Madrid, Universidad Complutense de Madrid, Madrid, Spain. 8. Research Unit, Hospital Galdakao-Usansolo, Galdakao, Spain; Health Services Research on Chronic Diseases Network (REDISSEC), Spain.
Abstract
BACKGROUND: While the proportion of colon cancer occurring in older patients is expected to increase, these patients may have more complications that may lead to serious consequences. The aim of this study was assess postoperative complications and their short-term consequences in colon cancer surgery according to age. PATIENTS AND METHODS: Patients undergoing surgery for primary invasive colon cancer in 22 centers between June 2010 and December 2012 were included. Presurgical and surgical variables were analyzed, and in-hospital major postoperative complications and its most serious consequence (no relevant, transfusion, reintervention, admission to the intensive care unit, or death) were estimated according to age group. Chi-square tests were used to analyze the possible associations between variables and age groups. RESULTS: Data from 1976 patients, mean (range) age 68 (24-97) years, 62% men, were analyzed; 52.2% were aged > 69 years and 17.7% were aged > 79 years. The complication rate was 25.3%, reaching 30.9% in those aged ≥ 80 years. Older age was associated with a higher rate of postoperative infections during the hospital stay. The most common surgical complication in patients aged > 85 years was dehiscence of the anastomosis (11.5%). About 5% of patients with major complications died in the hospital (11.1% of those aged 80-84 years and 14.3% aged > 85 years). Among patients aged > 85 years, 38.1% required transfusions. CONCLUSION: Older patients should receive appropriate functional preparation before the intervention, and when the risks of the intervention outweigh the potential benefits, a nonsurgical approach may be preferable.
BACKGROUND: While the proportion of colon cancer occurring in older patients is expected to increase, these patients may have more complications that may lead to serious consequences. The aim of this study was assess postoperative complications and their short-term consequences in colon cancer surgery according to age. PATIENTS AND METHODS: Patients undergoing surgery for primary invasive colon cancer in 22 centers between June 2010 and December 2012 were included. Presurgical and surgical variables were analyzed, and in-hospital major postoperative complications and its most serious consequence (no relevant, transfusion, reintervention, admission to the intensive care unit, or death) were estimated according to age group. Chi-square tests were used to analyze the possible associations between variables and age groups. RESULTS: Data from 1976 patients, mean (range) age 68 (24-97) years, 62% men, were analyzed; 52.2% were aged > 69 years and 17.7% were aged > 79 years. The complication rate was 25.3%, reaching 30.9% in those aged ≥ 80 years. Older age was associated with a higher rate of postoperative infections during the hospital stay. The most common surgical complication in patients aged > 85 years was dehiscence of the anastomosis (11.5%). About 5% of patients with major complications died in the hospital (11.1% of those aged 80-84 years and 14.3% aged > 85 years). Among patients aged > 85 years, 38.1% required transfusions. CONCLUSION: Older patients should receive appropriate functional preparation before the intervention, and when the risks of the intervention outweigh the potential benefits, a nonsurgical approach may be preferable.