Department of General Surgery, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, POB 12000, 91120, Jerusalem, Israel.
Department of Radiology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Tech Coloproctol. 2024 Nov 27;29(1):4. doi: 10.1007/s10151-024-03040-z.
Colorectal cancer resection in the elderly may be associated with significant morbidity. This study aimed to assess perioperative morbidity in elderly patients undergoing colorectal cancer resection and to investigate risk factors for postoperative complications.
Consecutive patients aged ≥ 75 years undergoing colorectal cancer resection with curative intent between January 2014 and December 2021 at our institution were included. We evaluated risk factors for postoperative complications, length of hospital stays (LOS), 30-day readmission, and 90-day mortality rates.
A total of 843 patients underwent colorectal cancer resection during the study period, of whom 202 patients were 75 years or older. Advanced age was associated with postoperative complications (Clavien-Dindo score > 3b, p = 0.001). Sarcopenia, preoperative plasma albumin < 3.5 g/dL, and open and urgent surgery were significantly correlated with major complications (p = 0.015, p = 0.022, p = 0.003, and p < 0.001, respectively). LOS was longer in elderly patients with a modified 5-item Frailty Index (5-mFI) ≥ 2 and low preoperative serum albumin levels, as well as following open surgery (p = 0.006, p = 0.001 and p < 0.001, respectively). Sarcopenia and preoperative plasma albumin < 3.5 g/dL were predictors for 90-day mortality (p = 0.004 and p > 0.001).
Advanced age, sarcopenia, preoperative hypoalbuminemia, 5-mFI ≥ 2, and open or urgent surgery may serve as predictors for postoperative morbidity in the elderly population.
老年人结直肠癌切除术可能与显著的发病率相关。本研究旨在评估老年患者接受结直肠癌切除术的围手术期发病率，并探讨术后并发症的危险因素。
连续纳入 2014 年 1 月至 2021 年 12 月期间在我院接受以治愈为目的的结直肠癌切除术且年龄≥75 岁的患者。我们评估了术后并发症、住院时间（LOS）、30 天再入院和 90 天死亡率的危险因素。
在研究期间，共有 843 例患者接受了结直肠癌切除术，其中 202 例患者年龄为 75 岁或以上。高龄与术后并发症（Clavien-Dindo 评分>3b，p=0.001）相关。肌肉减少症、术前血浆白蛋白<3.5 g/dL 以及开放性和紧急手术与主要并发症显著相关（p=0.015、p=0.022、p=0.003 和 p<0.001）。改良的 5 项虚弱指数（5-mFI）≥2 和低术前血清白蛋白水平以及开放性手术的老年患者 LOS 较长（p=0.006、p=0.001 和 p<0.001）。肌肉减少症和术前血浆白蛋白<3.5 g/dL 是 90 天死亡率的预测因素（p=0.004 和 p>0.001）。
高龄、肌肉减少症、术前低白蛋白血症、5-mFI≥2 以及开放性或紧急手术可能是老年人群术后发病率的预测因素。
