Abstract
Comorbidities had considerable effects on the development of postoperative ileus (POI). The primary aim of the present study was to determine the influence of the age-adjusted Charlson comorbidity index (ACCI) score on the risk of prolonged POI in patients with colorectal cancer who underwent surgical resection. Using the electronic Hospitalization Summary Reports, we identified 11,397 patients with colorectal cancer who underwent surgical resection from 2013 through 2015. Logistic regression models were applied to evaluate the effect of the ACCI score on the risk of prolonged POI. The ACCI score had a positive graded association with the risk of prolonged POI in both colon and rectal cancer (P for trend < 0.05). Among patients with rectal cancer, after adjusting for potential confounders, those with an ACCI score of 4–5 had a 108% higher risk of prolonged POI than those with an ACCI score of 0–1 (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.09–3.98), and those with an ACCI score of ≥ 6 had a 130% higher risk (OR, 2.30; 95% CI, 1.08–4.89). Among patients with colon cancer, those with an ACCI score of ≥ 6 had a 47% greater risk of prolonged POI than those with an ACCI score of 0–1 (OR, 1.47; 95% CI, 1.07–2.02). These findings suggested that a higher ACCI score was an independent predictor of the development of prolonged POI.
Highlights
Colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of cancer-related death globally
The Spearman correlation analysis showed that the prolonged postoperative ileus (POI) occurrence was positive related to adjusted Charlson comorbidity index (ACCI) groups in both rectal and colon cancer patients who underwent surgical resection (P < 0.001)
Age and medical comorbidities as measured by the validated ACCI had a considerable effect on the risk of prolonged POI in patients with CRC who had undergone surgical resection
Summary
Colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of cancer-related death globally. An epidemiological study demonstrated that the incidence of CRC was as high as 376.3 per 100,000 and the mortality rate was 191.0 per 100,000 in China in 2015 [4]. Surgical resection remains the primary modality of curative treatment for CRC [5, 6]. Prolonged postoperative ileus (POI) is a problematic and frequent complication following surgical resection of CRC [7]. A recent meta-analysis of 54 studies involving 18,983 patients who underwent colorectal surgery indicated that the incidence of prolonged POI in randomized controlled trials and non-randomized controlled trials was 10.2% and 10.3%, respectively [8]. Preoperative identification of risk factors is important for the prevention of prolonged POI
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