[The Association Française de Chirurgie (AFC) colorectal index: a reliable preoperative prognostic index in colorectal surgery].
BACKGROUND
Evaluation of outcome after colorectal surgery is always necessary. A new index which permits to appreciate preoperatively postoperative mortality after colorectal resection in colorectal cancer (CRC) and in diverticular disease has been published (i.e., Association Française de Chirurgie, AFC colorectal index).


METHODS
From November 2002 to July 2004, in-hospital mortality was analysed on 253 patients who underwent colic resection (N = 220, 87%) or rectal resection, with anastomosis (N = 175, 70%). Mortality was analysed according to emergency resection, neurological co morbidity, lost of weight more than 10% of weight, age older than 70 years.


RESULTS
Mean age of patients was 63 +/- 18 years (17-92) (45% older than 70 years), 26% of patients were ASA >or= III, 35% underwent surgery in emergency, and 12% underwent laparoscopic surgery. One hundred and fifteen (45%) patients underwent surgery for CRC and 50 (20%), for diverticular disease and 11 patients underwent surgery for ischemic colitis. Overall mortality rate was 10% (N = 26), it was 19% in emergency surgery versus 5% after elective surgery. Global morbidity was 38%, percentage of anastomotic leak was 8% (N = 14/175), reoperation was necessary in 14%. The mean length of stay was 13 +/- 8 days. Ten percent of patients necessitated unplanned readmission. After surgery for CCR or diverticular disease. -i) overall mortality was 9% - ii) among patients who had 0, 1, 2, or 3 predictive risk factors of mortality; mortality was 0% , 5% 15% and 33%. After surgery for other aetiology than CCR or diverticular disease, among patients who had 0, 1, 2, or 3 predictive risk factors of mortality; mortality was 0%, 12% 36% and 25%.


CONCLUSIONS
These results showed the reproducibility of the AFC colorectal index and its potential application in all aetiologies after colorectal surgery.
Duval
H
H
Service de chirurgie viscérale et digestive, hôpital Nord, Amiens, université de Picardie, place Victor-Pauchet, 80054 Amiens cedex 01, France.
Dumont
F
F
Vibert
E
E
Manaouil
D
D
Verhaeghe
P
P
Fuks
D
D
Bounicaud
D
D
Riboulot
M
M
Chatelain
D
D
Yzet
T
T
Mauvais
F
F
Lapôtre-Ledoux
B
B
Regimbeau
J-M
JM
D000368:Aged; D000714:Anastomosis, Surgical; D003108:Colonic Diseases / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000401:mortality*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011379:Prognosis; D012002:Rectal Diseases / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015431:Weight Loss