Comorbidity and the risk of anastomotic leak in Chinese patients with colorectal cancer undergoing colorectal surgery.
OBJECTIVE
Comorbidities had considerable effects on the prognosis in patients with colorectal cancer (CRC). The primary aim of the present study was to examine the influence of comorbidity on the risk of anastomotic leak (AL) in patients with CRC who underwent surgical resection.


METHODS
Using the electronic Hospitalization Summary Reports in the top-ranked public hospitals in China, we identified 11,397 patients with CRC undergoing resection surgery from 2013 through 2015. We estimated the risk of AL according to Charlson Comorbidity Index (CCI) score using logistic regression analysis, adjusting for age, sex, and geographic regions.


RESULTS
The incidence rate of AL in the study population was 1.8% (204/11,397). Multivariable analyses identified male sex and CCI score as independent risk factors for AL. The CCI score had a positive graded association with the risk of AL (P for trend = 0.006). The risk increased by an estimated 10.2% (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.03-1.18) for each additional 1 point in the CCI score. After adjusting for potential confounders, patients with a CCI score ≥3 had 1.82 times (95% CI, 1.24-2.69) higher risk of AL compared with patients with a CCI score of 0.


CONCLUSIONS
The findings suggested that CCI score was an independent risk factor for the development of AL in Chinese patients with CRC who underwent surgical resection.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China.
Yaohua
Y
Tian
Medical Informatics Center, Peking University, No.38 Xueyuan Road, Beijing, 100191, China.
Beibei
B
Xu
Medical Informatics Center, Peking University, No.38 Xueyuan Road, Beijing, 100191, China.
Guopei
G
Yu
National Healthcare Data Center, No.38 Xueyuan Road, Beijing, 100191, China.|Hospital Administration Department, Peking University, No.38 Xueyuan Road, Beijing, 100191, China.
Yan
Y
Li
Medical Informatics Center, Peking University, No.38 Xueyuan Road, Beijing, 100191, China. ymauil@bjmu.edu.cn.|National Healthcare Data Center, No.38 Xueyuan Road, Beijing, 100191, China. ymauil@bjmu.edu.cn.
Hui
H
Liu
D057868:Anastomotic Leak / Q000453:epidemiology* / Q000209:etiology*; D044466:Asian People; D002681:China / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D003107:Colorectal Surgery / Q000009:adverse effects*; D015897:Comorbidity; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors
Anastomotic leak; Charlson Comorbidity Index; China; Colorectal cancer