Abstract
BackgroundColorectal cancer surgery is complex and can result in severe post-operative complications. Optimisation of surgical outcomes requires a thorough understanding of the background complexity and comorbid status of patients.AimThe aim of this study is to determine whether certain pre-existing comorbidities are associated with high grade post-operative complications following colorectal cancer surgery. The study also aims to define the prevalence of demographic, comorbid and surgical features in a population undergoing colorectal cancer resection.MethodA colorectal cancer database at The Prince Charles Hospital was established to capture detailed information on patient background, comorbidities and clinicopathological features. A single-centre retrospective study was undertaken to assess the effect of comorbidities on post-operative outcomes following colorectal cancer resection. Five hundred and thirty-three patients were reviewed between 2010–2018 to assess if specific comorbidities were associated with higher grade post-operative complications. A Clavien-Dindo grade of three or higher was defined as a high grade complication.ResultsFifty-eight percent of all patients had an ASA grade of ASA III or above. The average BMI of patients undergoing resection was 28 ± 6.0. Sixteen percent of all patients experienced a high grade complications. Patients with high grade complications had a higher mean average age compared to patients with low grade or no post-operative complications (74 years vs 70 years, p = 0.01). Univariate analysis revealed patients with atrial fibrillation, COPD, ischaemic heart disease and heart failure had an increased risk of high grade complications. Multivariate analysis revealed pre-existing atrial fibrillation (OR 2.70, 95% CI 1.53–4.89, p <0.01) and COPD (OR 2.02 1.07–3.80, p = 0.029) were independently associated with an increased risk of high grade complications.ConclusionPre-existing atrial fibrillation and COPD are independent risk factors for high grade complications. Targeted perioperative management is necessary to optimise outcomes.
Highlights
Colorectal cancer (CRC) is the third most common cancer in Australia, with over 17 000 people diagnosed annually [1]
Multivariate analysis revealed pre-existing atrial fibrillation
While complications are a known entity with colorectal surgery, there is an increasing need to examine our patients in order to optimise surgical outcomes [2,3,4]
Summary
Colorectal cancer (CRC) is the third most common cancer in Australia, with over 17 000 people diagnosed annually [1]. Surgical resection of colorectal cancer is the cornerstone of treatment, colorectal surgery can be complex. While complications are a known entity with colorectal surgery, there is an increasing need to examine our patients in order to optimise surgical outcomes [2,3,4]. This is especially relevant given the aging and highly comorbid population who present with colorectal cancer. Colorectal cancer surgery is complex and can result in severe post-operative complications.
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