Non-home discharge in the octogenarian and nonagenarian colorectal cancer population: a retrospective cohort study.

PURPOSE

This study aims to determine the rate of non-home discharge (NHD) and identify factors associated with non-home discharge in a colorectal cancer (CRC) population of adults aged 80 years and older. This is the first study looking specifically at NHD as an outcome in the ≥ 80 years colorectal cancer cohort.

METHODS

This is a single-centre retrospective exploratory observational study from a high-volume colorectal cancer unit. Patients aged ≥ 80 years from a prospectively collected CRC database from 2013 to 2020 were included. Electronic medical records were assessed to obtain demographic, clinical, functional and discharge data. Univariable and multivariable logistic regression analyses were performed to identify factors associated with NHD the primary study outcome. Secondary outcomes included discharge disposition and functional decline.

RESULTS

Two hundred forty-two patients aged ≥ 80 years underwent CRC resection. Alo, 234 patients and 221 patients were included in the overall and subgroup non-home discharge analysis. The non-home discharge rate was 19.9% in the cohort that pre-operatively were from home. On multivariable logistic regression, after adjusting for other significant variables, frailty (odds ratio (OR) 2.91, 95% CI 1.25-6.75, p = 0.013), severe complications (OR 3.92, 95% CI 1.40-10.97, p = 0.009) and an open operation (OR 3.93, 95% CI 1.87-8.24, p < 0.001) were associated with a significantly higher rate of NHD. The incidence of functional decline from those at home was 72.4% in the non-home discharge group and 16.7% in those who returned home (p < 0.001).

CONCLUSION

This is the first paper describing the overall rate and identifying factors associated with non-home discharge specifically in the ≥ 80 years CRC population. Prospective studies are required to investigate causality and interventions to reduce non-home discharge rates.