Prognostic Factors Associated with Surgical Mortality Conferred by Emergency Operation in Colorectal Cancer

Lee, Ho Jin; Oh, Jae Hwan; Lee, Jung Nam; Baek, Jeong Heum; Chung, Min; Lee, Woon Kee; Kim, Keon Kuk; Park, Heung Kyu; Min, Seung Kee; Lee, Young Don; Lee, Tae Hun

Abstract

PURPOSE
Compared with elective surgery, emergency surgery for colorectal cancer has been reported to be associated with high mortality, though little is known about the prognostic factors associated with surgical mortality. Above all, a distinction between patients with high and low mortalities might be helpful for perioperative management. The purpose of this study was to identify prognostic factors associated with surgical mortality due to an emergency operation.
METHODS
Ninety-five cases of emergency surgery for colorectal cancer were performed from 1998 through 2005. The genders and the ages of the patients, the duration of symptoms, the APACHE score, the cancer location, the presence of perforation, the operative type, and the disease stage were determined as prognostic factors. The patients were examined retrospectively to establish any relationships between the prognostic factors and surgical mortality.
RESULTS
In the univariate analysis, significantly higher surgical mortality rates were found in patients who were more than 75 years old, who had an APACHE II score above 10, and who had a perforation (P<0.05). Gender, duration of symptoms, cancer location, operation type, and disease stage were, however, not associated with a significantly higher surgical mortality (P>0.05). Multivariate analysis showed that age and APACHE II score were related to surgical mortality. The surgical mortality rate for colorectal cancer in an emergency situation was 8.4%.
CONCLUSIONS
Prognostic factors of significance associated with surgical mortality due to an emergency operation were age (> or = 75) and APACHE II score (>10). Careful attention is needed for appropriate perioperative management of patients with these risk factors.