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Published on: September 27, 2024
Risk factors for postoperative complications after colorectal surgery in patients aged ≥ 80 years: A multicenter
Hirofumi Hasuda1, Ryota Nakanishi2, Taichiro Nagai2
1Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division, National Hospital Organization Kyushu Medical Center, Jigyohama 1-8-1, Chuou-ku, Fukuoka, 810-8563, Japan. hausda.hirofumi@gmail.com.
Purpose:
To identify the perioperative risk factors for postoperative complications in patients aged ≥ 80 years.
Methods:
We retrospectively analyzed 2,072 consecutive patients who underwent colorectal surgery at seven institutions between January 2021 and December 2023 and compared the perioperative outcomes between patients aged ≥ 80 (n = 464) and ≤ 79 years (n = 1,608).
Results:
Patients aged ≥ 80 years had an American Society of Anesthesiologists Physical Status (ASA-PS) score of ≥ 3 (P < 0.0001) and more comorbidities. Minimally invasive surgery was performed less frequently (P < 0.0001), with a shorter surgical duration (P = 0.0003) and greater intraoperative bleeding (P = 0.04). Postoperative pneumonia (P = 0.0005) and urinary disorder complications after rectal surgery (P = 0.03) were more frequent in patients aged ≥ 80 years. A multivariate analysis identified male sex (P = 0.02), ASA-PS ≥ 3 (P = 0.005), and intraoperative bleeding (P = 0.02) as independent risk factors for pneumonia. Intraoperative bleeding (P = 0.002) and anastomosis (P = 0.03) were significant risk factors for urinary disorders after rectal surgery. Minimally invasive surgery in older adults resulted in a longer surgical duration (P < 0.0001), less bleeding (P < 0.0001), and fewer complications than conventional surgery.
Conclusion:
Postoperative pneumonia and urinary complications after rectal surgery are common in older adult patients. Minimally invasive approaches may reduce the risk of complications.
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