title: 30-Day, 90-day and 1-year mortality after emergency colonic surgery.
abstract: OBJECTIVE
  Emergency surgery is an independent risk factor in colonic surgery resulting in high 30-day mortality. The primary aim of this study was to report 30-day, 90-day and 1-year mortality rates after emergency colonic surgery, and to report factors associated with 30-day, 90-day and 1-year mortality. Second, the aim was to report 30-day postoperative complications and their relation to in-hospital mortality.
  
  
  METHODS
  All patients undergoing acute colonic surgery in the period from May 2009 to April 2013 at Copenhagen University Hospital Herlev, Denmark, were identified. Perioperative data was collected from medical journals.
  
  
  RESULTS
  30-day, 90-day and 1-year mortality was 21, 30 and 41%, respectively. Age >70 years, Performance status ≥3 and resection with stoma were independent factors associated with 30-day mortality. Age >70 years, Performance status ≥3, resection with stoma and malignant disease were independent risk factors associated with 90-day mortality. Age >70 years, Performance status ≥3, resection with stoma and malignant disease were independent factors associated with 1-year mortality. Overall, 30-day complication rate was 63%, with cardiopulmonary complications leading to most postoperative deaths.
  
  
  CONCLUSIONS
  Mortality and complication rates after emergency colonic surgery are high and associated with patient related risk factors that cannot be modified, but also treatment related outcomes that are modifiable. An increased focus on medical and other preventive measures should be explored in the future.
authors.affiliation: Department of Surgery, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730, Herlev, Denmark. torben.pedersen28@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Pedersen
authors.affiliation: Department of Surgery, Center for Surgical Science, Zealand University Hospital, Copenhagen University, Copenhagen, Denmark.
authors.forename: S K
authors.initials: SK
authors.lastname: Watt
authors.affiliation: Department of Surgery, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730, Herlev, Denmark.
authors.forename: M-B
authors.initials: MB
authors.lastname: Tolstrup
authors.affiliation: Department of Surgery, Center for Surgical Science, Zealand University Hospital, Copenhagen University, Copenhagen, Denmark.
authors.forename: I
authors.initials: I
authors.lastname: Gögenur
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000401:mortality* / Q000601:surgery; D003718:Denmark; D004638:Emergency Treatment / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007415:Intestinal Obstruction / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Colon; Emergency surgery; Outcome; Risk factors