New prognostic risk score for predicting in-hospital mortality in geriatric patients undergoing colorectal cancer surgery: U.S. Nationwide Inpatient Sample analysis

Abstract

ObjectivesTo develop a new prognostic risk score index for predicting in-hospital mortality in geriatric patients undergoing colorectal cancer resection. Participants and methodsA retrospective study included 111,976 patients with colorectal cancer who were ≥ 65 years of age and underwent resection. The records were extracted from the Nationwide Inpatient Sample (NIS) database between 2005 and 2014. Univariate and multivariate analyses were conducted to determine the associations of in-hospital mortality and demographics, number of comorbidities, clinical and hospital-related characteristics. A prognostic risk score index on in-hospital mortality was established based on the odds ratios of the significant factors. Results30 points were distributed across the identified predictors of in-hospital mortality. Emergent admission had the greatest impact on mortality (adjusted OR = 3.01) and received the highest ranking with 7 points. The odds were followed by age ≥85 years old and number of comorbidities ≥3 (adjusted OR = 2.58 and 1.99, respectively), which received a rank of 5 points. The other elements of the risk score index were age 75–84 (4 points), male (3 points), tumor located in the colon or with distant metastasis (2 points), and with two comorbidities or socioeconomic status <Q4 (1 point). ConclusionThis study proposes a novel risk score index for predicting in-hospital mortality in geriatric colorectal cancer patients undergoing resection. This risk score may be helpful for clinicians in decision-making and risk stratification at the pre-surgical phase.