Home E-Weekly April 15, 2014

Older Patients at Risk After Colon Surgery

Published: April 14, 2014

Patients 65 years or older are at increased risk of suffering complications after colorectal cancer surgeries, according to a new study published in JAMA Surgery.

Researchers at the University of California Irvine School of Medicine examined the surgical outcomes of more than 1 million patients ranging in age from 45 years to 85 years and older who underwent surgery between 2001and 2010. They discovered that nearly 85% of the patients were older than 65 years, and patients 80 years and older were 1.7 times more likely to be urgently hospitalized than patients younger than 65 years.

It is important that the surgical community recognizes this shift in the patient population and prepares accordingly, given the expected higher mortality and morbidity rates, note the researchers.

Once admitted, older patients were at higher risk of suffering complications — acute renal failure, cardiac complications, respiratory failure, urinary tract infections and pneumonia — incurred nearly $10,000 more in hospital charges and remained hospitalized 2.5 days longer than younger patients.

The researchers did report some good news. The total number of colon cancer surgeries decreased by 5.1% annually throughout the study period, with the largest decrease seen in the elderly: 7.0% annually compared with 2.2% in patients aged 45 to 64 years. According to the study, the lower number of surgeons is likely attributable to improved access to screening for colorectal cancer, especially among elderly patients. Overall mortality during the study decreased by a mean of 6.6%, with the most considerable decrease (9.1%) observed in patients 85 years and older.

Notably, say the researchers, older patients require "vigilant postoperative treatment and anticipation of their social needs, which have to be factored into their preoperative counseling and postoperative planning."

Daniel Cook

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