title: [Objective assessment of the level of comorbidity in geriatric patients with bowel cancer: relationship between the surgical results and survival].
abstract: OBJECTIVE
  Bowel cancer is increasing in prevalence in geriatrics (older than 65 years). The influence of comorbidities on the post-surgical results of bowel cancer is not well known. Our aim was to assess the comorbidities using the Charlson index in a geriatric population subjected to bowel cancer surgery, and analyse their influence on the postoperative results and the mortality rate.
  
  
  METHODS
  The study included 115 patients (over 65 years-old and with 5 years follow-up) subjected to bowel cancer surgery in the Vic General Hospital (Barcelona) between the years 2003 and 2005. Three comorbidity groups were established using the Charlson index: absent (0 points), low (1-2 points), and high (≥ 3 points). The postoperative medical and surgical complications, as well as mortality, were determined in each of the groups.
  
  
  RESULTS
  The relative risk of a medical complication adjusted for age and stage was 2.7 (95% CI; 1.07-7) and 4.3 (95% CI; 1.3-14) times higher in the low and high comorbidity groups, respectively. There were no differences in post-surgical complications between the comorbidity groups. The length of hospital stay was higher in the in the high comorbidity group compared to the group with no comorbidity (17 days compared to 26 days, P=.02). The relative risk of mortality adjusted for age and stage was 1.7 (95% CI; 1.04-3) and 2.5 (95% CI; 1.3-4.6) in the low and high comorbidity groups, respectively.
  
  
  CONCLUSIONS
  The presence of any level of comorbidity measured by the Charlson index is an independent predictive factor of medical complications and of an increase in overall mortality in geriatric patients subjected to bowel cancer surgery.
authors.affiliation: Servicio de Cirugía General, Consorci Hospitalari de Vic, Barcelona, Spain. txellmedarde@gmail.com
authors.forename: Meritxell
authors.initials: M
authors.lastname: Medarde-Ferrer
authors.forename: Constantí
authors.initials: C
authors.lastname: Serra-Genís
authors.forename: Josep
authors.initials: J
authors.lastname: Roca
authors.forename: Xavier
authors.initials: X
authors.lastname: Quer
authors.forename: Francisco
authors.initials: F
authors.lastname: Sala
authors.forename: M Antonia
authors.initials: MA
authors.lastname: Palau
authors.forename: Manel
authors.initials: M
authors.lastname: Guixà
authors.forename: Jordi
authors.initials: J
authors.lastname: de Cózar
authors.forename: Joan
authors.initials: J
authors.lastname: Molinas
authors.forename: Jordi
authors.initials: J
authors.lastname: Tortras
authors.forename: Enric
authors.initials: E
authors.lastname: de Caralt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome