Metabolic Multimorbidity and Acute Obstructive Presentation in Colon Cancer: A 677-Patient Hospital-Based Cohort

Background/Objectives: Metabolic comorbidities and systemic inflammation are implicated in colon carcinogenesis, yet their relationship with acute obstructive presentation and early in-hospital course remains unclear. This study evaluated whether age, metabolic multimorbidity, and inflammatory-metabolic biomarkers are associated with obstruction severity and length of stay in a surgical colon cancer cohort. Methods: We analyzed 677 consecutive adults undergoing surgery for histologically confirmed colon cancer. Acute presentation was categorized as no obstruction, subocclusive syndrome, or frank obstruction. Predictors included age, comorbidity count (multimorbidity defined as ≥2), diabetes, hypertension, and preoperative biomarkers (C-reactive protein (CRP), lipids, glucose; neutrophil-to-lymphocyte ratio (NLR)/platelet-to-lymphocyte ratio (PLR)/C-reactive protein-to-albumin ratio (CAR)where available). Multivariable logistic and ordinal regression assessed obstructive presentation; linear regression assessed length of stay. Results: Subocclusion or obstruction occurred in 34.8% of patients. In multivariable logistic regression, age was independently associated with obstructive presentation (odds ratio (OR) 1.016 per year; 95% confidence interval (CI) 1.001-1.032), while comorbidity count and CRP were not. In an ordinal model, age increased the odds of more severe presentation (OR 1.018 per year), whereas diabetes was inversely associated (OR 0.573). Length of stay was independently associated only with presentation severity (β = -0.959 days per category). Correlations between inflammatory indices and length of stay were negligible. Conclusions: In this hospital-based surgical cohort, age showed a modest association with obstructive presentation, while metabolic multimorbidity and routine inflammatory markers provided limited discrimination for obstruction or early in-hospital resource use.