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Predictors of in-hospital mortality in colorectal surgery

This month's issue of the Journal of the American College of Surgeons identifies predictors of in-hospital mortality in colon and rectal surgery.

News image

Knowledge of the independent risk factors for mortality in colon and rectal surgery can aid surgeons in surgical decision making and in providing patients with appropriate information about the risks of surgery.

Dr Michael Stamos and colleagues from California, USA identified the risk factors for mortality that are associated with colon and rectal surgery.

Using the Nationwide Inpatient Sample database, the team examined the clinical data of patients who underwent colon and rectal resection from 2006 to 2008.

Multivariate regression analysis was performed to identify factors predictive of in-hospital mortality.
The rate of in-hospital mortality was about 5%
Journal of the American College of Surgeons

A total of 975,825 patients underwent colon and rectal resection during this period.

Overall, the researchers found that the rate of in-hospital mortality was about 5%.

Mortality was lower after laparoscopic compared with open operation.

Using multivariate regression analysis, significant risk factors for in-hospital mortality were emergent surgery, liver disease, age older than 65 years, total colectomy, chronic renal failure, and malignant tumor.

In addition, open operation, peripheral vascular disease, diverticulitis, transverse colectomy, chronic lung disease, and ulcerative colitis were significant risk factors.

Left colectomy, alcohol abuse, male sex, nonteaching hospital, and African-American race were also significant risk factors.

The tean found no association between hypertension, diabetes, congestive heart failure, obesity, smoking, proctectomy, sigmoidectomy, or Crohn disease and in-hospital mortality.

Dr Stamos' team concludes, "In patients undergoing colorectal surgery, emergent surgery, liver disease, total colectomy, age older than 65 years, chronic renal failure, and malignant tumor are the major risk factors for in-hospital mortality."

J Am Coll Surg 2012: 215(2): 255-261
21 August 2012

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