Assessing risk factors for adverse outcomes in emergent colorectal surgery.
BACKGROUND
A variety of factors influence the increased morbidity and mortality seen in patients undergoing emergent colon surgery. Understanding comorbid conditions and variations in preoperative laboratory values that effect both morbidity and mortality can influence clinical decision making.


METHODS
During a 5-year period 185 patients underwent colon surgery at the Veterans Administration Hospital in West Haven, CT. Through a retrospective chart review patients were classified as having either emergent or elective surgery. Patient characteristics and postoperative outcomes were analyzed using Chi Square and logistic regression models.


RESULTS
Differences existed in preoperative variables as well as postoperative outcomes when comparing emergent and elective paitents. In those patients undergoing emergent colorectal surgery, both morbidity and mortality were increased and overall survival decresed when compared to a non-emergent population.


CONCLUSIONS
Through identification of preoperative variables such as a hematocrit <30, the use of steroids, an albumin <3.5, and a creatinine of >1.4, those patients at risk for postoperative morbidity and mortality can be identified and clinical decision making can be appropriately adjusted.
Yoo
Peter S
PS
VA Connecticut Healthcare, Yale University School of Medicine, Department of Surgery, 330 Cedar Street, LH 118, P.O. Box 208062, New Haven, CT 06520-8062, USA.
Mulkeen
Abby L
AL
Frattini
Jared C
JC
Longo
Walter E
WE
Cha
Charles H
CH
D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome