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Emergency surgery for colonic cancer in a defined population.

Authors :
Jestin P
Nilsson J
Heurgren M
Påhlman L
Glimelius B
Gunnarsson U
Source :
The British journal of surgery [Br J Surg] 2005 Jan; Vol. 92 (1), pp. 94-100.
Publication Year :
2005

Abstract

Background: The aim of this study was to identify risk factors in emergency surgery for colonic cancer in a large population and to investigate the economic impact of such surgery.<br />Methods: Data from the colonic cancer registry (1997-2001) of the Uppsala/Orebro Regional Oncological Centre were analysed and classified by hospital category. Some 3259 patients were included; 806 had an emergency and 2453 an elective procedure. Data for calculating effects on health economy were derived from a national case-costing register.<br />Results: Patients who had emergency surgery had more advanced tumours and a lower survival rate than those who had an elective procedure (5-year survival rate 29.8 versus 52.4 per cent; P < 0.001). There was a stage-specific difference in survival, with poorer survival both for patients with stage I and II tumours and for those with stage III tumours after emergency compared with elective surgery (P < 0.001). Emergency surgery was associated with a longer hospital stay (mean 18.0 versus 10.0 days; P < 0.001) and higher costs (relative cost 1.5 (95 per cent confidence interval 1.4 to 1.6)) compared with elective surgery. The duration of hospital stay was the strongest determinant of cost (r(2) = 0.52, P < 0.001).<br />Conclusion: Emergency surgery for colonic cancer is associated with a stage-specific increase in mortality rate.

Details

Language :
English
ISSN :
0007-1323
Volume :
92
Issue :
1
Database :
MEDLINE
Journal :
The British journal of surgery
Publication Type :
Academic Journal
Accession number :
15521083
Full Text :
https://doi.org/10.1002/bjs.4780