Emergency Colectomies in the Elderly Population-Perioperative Mortality Risk-Factors and Long-Term Outcomes

Area of Science:

• Colorectal Surgery
• Geriatric Surgery
• Surgical Outcomes Research

Background:

• Emergency colectomies are increasing in the aging population.
• Limited data exists on short- and long-term outcomes for elderly patients undergoing these procedures.

Purpose of the Study:

• To investigate mortality and identify risk factors for emergent colectomies in older versus younger patients.
• To compare short- and long-term outcomes across different age groups.

Main Methods:

• Retrospective study of 613 patients undergoing emergent colectomy.
• Exclusion of patients with metastatic disease, trauma, or recent prior colectomy.
• Patients categorized into four age groups: 18-59, 60-69, 70-79, and ≥80 years.

Main Results:

• Thirty-day mortality rates increased significantly with age: 3.2% (18-59), 11% (60-69), 29.3% (70-79), and 37.8% (≥80).
• Risk factors for mortality varied by age group, including ASA score, WBC count, ADL dependency, albumin, creatinine, and dementia in older groups.
• Long-term survival showed significant differences across age groups.

Conclusions:

• Perioperative mortality for emergency colectomy escalates with patient age.
• Patients over 80 have exceptionally high mortality rates, posing a significant healthcare burden.
• Pre-operative risk assessment and early screening for colonic pathologies in the elderly are crucial for potentially reducing mortality through elective surgery.