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International Journal of Colorectal Disease

, Volume 34, Issue 1, pp 63–69 | Cite as

Short-term outcome of emergency colorectal cancer surgery: results from Bi-National Colorectal Cancer Audit

  • Chun Hin Angus LeeEmail author
  • Joseph Cherng Huei Kong
  • Alexander G. Heriot
  • Satish Warrier
  • John Zalcberg
  • Paul Sitzler
Original Article
  • 197 Downloads

Abstract

Backgrounds

A significant number of patients with colorectal cancer will have an emergency presentation requiring surgery. This study aims to evaluate short-term outcomes for patients undergoing emergency colorectal cancer surgery in Australasia.

Methods

All consecutive CRC from the Bi-National Colorectal Cancer Audit Database was interrogated from 2007 to 2016. Short-term outcomes including length of stay, complication rate and mortality rate were compared between the emergency and elective groups. Logistic regression analysis was performed to identify independent predictors for inpatient mortality. A predictive model for inpatient mortality was constructed using these variables, and its accuracy was then validated by the Bootstrap re-sampling method.

Results

Of 15,676 colorectal cancer cases identified, 13.6% were emergency cases. The emergency group had a higher rate of surgical and medical complications (26.7% vs 22.6%, p < 0.001; 22.8 vs 13.8%, p < 0.001, respectively). Higher inpatient mortality rate was also observed in the emergency group (3.4% vs 2.6%, p = 0.023). Independent predictors for inpatient survival included age, American Society Anaesthesiologists score, emergency surgery and tumour stage. In addition, postoperative complications such as anastomotic leak (odds ratio [OR] 3.78, p < 0.001), sepsis (OR 2.85, p < 0.001) and medical complications (OR 13.88, p < 0.001) had a significant impact in survival in the emergency group. Receiver operating characteristics curve for inpatient mortality was 0.913.

Conclusion

Emergency colorectal cancer surgery carries significant morbidity and mortality. Recognition of the increasing rate of postoperative complications may help minimise the detrimental impact of this event on overall outcomes.

Keywords

Emergency colorectal surgery Colorectal cancer Postoperative outcome 

Notes

Acknowledgements

We would like to acknowledge and thank the Bi-National Colorectal Cancer Audit and all the surgeons who contribute to the audit, without whom this study would not be possible. We thank Epworth Healthcare for all the support and assistance.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

384_2018_3169_MOESM1_ESM.docx (23 kb)
ESM 1 (DOCX 22 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018
corrected publication 2018

Authors and Affiliations

  1. 1.Epworth HealthcareMelbourneAustralia
  2. 2.Division of Cancer SurgeryPeter MacCallum Cancer CentreMelbourneAustralia
  3. 3.Cancer Research Program, School of Public Health & Preventive Medicine, Faculty of MedicineMonash UniversityMelbourneAustralia

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