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Increased long‐term mortality after emergency colon resections
Author(s) -
Fahim M.,
Dijksman L. M.,
Nat P.,
Derksen W. J. M.,
Biesma D. H.,
Smits A. B.
Publication year - 2020
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.15238
Subject(s) - medicine , interquartile range , emergency surgery , hazard ratio , elective surgery , proportional hazards model , colorectal cancer , surgery , emergency department , emergency medicine , confidence interval , cancer , psychiatry
Abstract Aim Emergency surgery is a known predictor for 30‐day mortality. However, its relationship with long‐term mortality is still a matter of debate. The aim of this study was to analyse the effect of emergency surgery compared with elective surgery on long‐term survival. Method Data from the Dutch Colorectal Audit and the Dutch Cancer Centre registry of a large nonacademic teaching hospital were used to analyse outcomes of patients who underwent surgery for colon cancer from 2009 until 2017. Univariable and multivariable Cox regression were used to assess the effect of emergency surgery on long‐term mortality with adjustment for patient, tumour and treatment characteristics. Results A total of 1139 patients with a median follow‐up of 40 months (interquartile range 23–65 months) were included. Emergency surgery was performed in 158 patients (14%). The 5‐year survival after emergency surgery was 46% compared with 72% after elective surgery. After adjusting for baseline differences there was an independent and significant association between emergency surgery and increased long‐term mortality (hazard ratio 1.79, 95% CI 1.28–2.51, P = 0.001). Conclusion Emergency surgery for colon cancer seems to lead to a significantly increased risk of long‐term mortality compared with elective surgery. Detection and treatment of early symptoms that can lead to emergency surgery might be the way forward.