title: Nonelective colon cancer resections in elderly patients: results from the dutch surgical colorectal audit.
abstract: OBJECTIVE
  The aim of the study was to assess which factors contribute to postoperative mortality, especially in elderly patients who undergo emergency colon cancer resections, using a nationwide population-based database.
  
  
  METHODS
  6,161 patients (1,172 nonelective) who underwent a colon cancer resection in 2010 in the Netherlands were included. Risk factors for postoperative mortality were investigated using a multivariate logistic regression model for different age groups, elective and nonelective patients separately.
  
  
  RESULTS
  For both elective and nonelective patients, mortality risk increased with increasing age. For nonelective elderly patients (80+ years), each additional risk factor increased the mortality risk. For a nonelective patient of 80+ years with an American Society of Anesthesiologists score of III+ and a left hemicolectomy or extended resection, postoperative mortality rate was 41% compared with 7% in patients without additional risk factors.
  
  
  CONCLUSIONS
  For elderly patients with two or more additional risk factors, a nonelective resection should be considered a high-risk procedure with a mortality risk of up to 41%. The results of this study could be used to adequately inform patient and family and should have consequences for composing an operative team.
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: N E
authors.initials: NE
authors.lastname: Kolfschoten
authors.forename: M W J M
authors.initials: MW
authors.lastname: Wouters
authors.forename: G A
authors.initials: GA
authors.lastname: Gooiker
authors.forename: E H
authors.initials: EH
authors.lastname: Eddes
authors.forename: J
authors.initials: J
authors.lastname: Kievit
authors.forename: R A E M
authors.initials: RA
authors.lastname: Tollenaar
authors.forename: P J
authors.initials: PJ
authors.lastname: Marang-van de Mheen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality* / Q000601:surgery*; D003082:Colectomy / Q000401:mortality*; D003110:Colonic Neoplasms / Q000401:mortality* / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors