Department of Medical and Surgical Sciences, University of Foggia, Luigi Pinto Street, No. 1, 71122 Foggia, Italy.
Department of Surgery and Traumatology, Hospital Lorenzo Bonomo, 76123 Andria, Italy.
Medicina (Kaunas). 2022 Aug 6;58(8):1062. doi: 10.3390/medicina58081062.
Colon diseases can turn in a clinical emergency with the onset of some important complications. Some critical conditions are more common in aged patients because they are frailer. The aim of this study is to examine patients over 80 years of age who are undergoing emergency colorectal surgery, and evaluating the aspects associated with post-operative complications and other problems in the short term. From November 2020 to February 2022, we included 32 consecutive patients older than 80 undergoing emergency surgery due to colon diseases. We collected and analysed all demographic and operative data, and then applied CR-POSSUM score and correlated this with postoperative hospital stay and the onset of postoperative complications according to the Clavien Dindo classification. Postoperative factors were selectively evaluated based on the clinical scenario and different colic pathologies. There were no statistically significant differences, in terms of postoperative hospital stay, postoperative complications, reoperation rate and 30-day mortality. The number of cases of blood transfusions was significant and was more numerous in cases of intestinal perforation and bleeding cases. The value of the Operative Severity Score in bowel perforations was significantly higher. The use of a score to stratify the risk is a useful tool, especially in elderly patients undergoing emergency surgery. The CR-POSSUM score was important for predicting morbidity in our study. Emergency manifestations of colon diseases in the elderly show higher morbidity and mortality rates. The effect of age on outcome is a concept that needs to be emphasized, so further investigation is needed.
结直肠疾病可因某些重要并发症的发生而转为临床急症。一些危急情况在老年患者中更为常见,因为他们的身体更为脆弱。本研究旨在检查因结直肠疾病而行急症手术的 80 岁以上患者,并评估与术后短期并发症和其他问题相关的方面。
2020 年 11 月至 2022 年 2 月,我们纳入了 32 例因结直肠疾病而接受急症手术的 80 岁以上连续患者。我们收集和分析了所有的人口统计学和手术数据,然后应用 CR-POSSUM 评分,并根据 Clavien Dindo 分类将其与术后住院时间和术后并发症的发生相关联。
根据临床情况和不同的结肠病变,选择性地评估术后因素。在术后住院时间、术后并发症、再次手术率和 30 天死亡率方面无统计学差异。输血病例数有显著差异,肠穿孔和出血病例较多。肠穿孔的手术严重度评分值显著更高。
使用评分来分层风险是一种有用的工具,尤其是在接受急症手术的老年患者中。在本研究中,CR-POSSUM 评分对于预测发病率很重要。老年人结直肠疾病的急症表现显示出更高的发病率和死亡率。年龄对结果的影响是一个需要强调的概念,因此需要进一步研究。