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Factors Predicting Morbidity and Mortality in Emergency Colorectal Procedures in Elderly Patients

Factors Predicting Morbidity and Mortality in Emergency Colorectal Procedures in Elderly Patients ORIGINAL ARTICLE Factors Predicting Morbidity and Mortality in Emergency Colorectal Procedures in Elderly Patients Edward A. McGillicuddy, MD; Kevin M. Schuster, MD; Kimberly A. Davis, MD; Walter E. Longo, MD Objective: To identify rapidly modifiable risk factors obstructing or perforated colorectal carcinoma (30%) and that would improve surgical outcomes in elderly pa- perforated diverticulitis (25%). Average age at presen- tients undergoing emergent colorectal procedures who tation was 78.1 years, and in-hospital mortality was 15%. are at high risk for morbidity and mortality. One hundred one patients (35%) experienced a total of 195 complications. Pneumonia (25%), persistent or re- Design: Retrospective review. Patients were identified current respiratory failure (15%), and myocardial infarc- on the basis of Current Procedural Terminology codes and tion (12%) were the most frequent complications. Op- admission through the emergency department. Medical erative time, shock, renal insufficiency, and significant records were reviewed and data were abstracted for co- intra-abdominal contamination or frank peritonitis were morbidities, procedural details, and in-hospital morbid- associated with morbidity. Age, septic shock at presen- ity and mortality. tation, large estimated intraoperative blood loss, delay to operation, and development of a complication were Setting: University tertiary referral center. associated with in-hospital mortality. Patients: Two http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Factors Predicting Morbidity and Mortality in Emergency Colorectal Procedures in Elderly Patients

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References (41)

Publisher
American Medical Association
Copyright
Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/archsurg.2009.203
pmid
20026835
Publisher site
See Article on Publisher Site

Abstract

ORIGINAL ARTICLE Factors Predicting Morbidity and Mortality in Emergency Colorectal Procedures in Elderly Patients Edward A. McGillicuddy, MD; Kevin M. Schuster, MD; Kimberly A. Davis, MD; Walter E. Longo, MD Objective: To identify rapidly modifiable risk factors obstructing or perforated colorectal carcinoma (30%) and that would improve surgical outcomes in elderly pa- perforated diverticulitis (25%). Average age at presen- tients undergoing emergent colorectal procedures who tation was 78.1 years, and in-hospital mortality was 15%. are at high risk for morbidity and mortality. One hundred one patients (35%) experienced a total of 195 complications. Pneumonia (25%), persistent or re- Design: Retrospective review. Patients were identified current respiratory failure (15%), and myocardial infarc- on the basis of Current Procedural Terminology codes and tion (12%) were the most frequent complications. Op- admission through the emergency department. Medical erative time, shock, renal insufficiency, and significant records were reviewed and data were abstracted for co- intra-abdominal contamination or frank peritonitis were morbidities, procedural details, and in-hospital morbid- associated with morbidity. Age, septic shock at presen- ity and mortality. tation, large estimated intraoperative blood loss, delay to operation, and development of a complication were Setting: University tertiary referral center. associated with in-hospital mortality. Patients: Two

Journal

JAMA Surgery – American Medical Association

Published: Dec 1, 2009

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