Development of an American College of Surgeons National Surgery Quality Improvement Program: Morbidity and Mortality Risk Calculator for Colorectal Surgery

Cohen, Mark E.; Bilimoria, Karl Y.; Ko, Clifford Y.; Hall, Bruce L.

doi:10.1016/j.jamcollsurg.2009.01.043

Cited by 333 publications

(220 citation statements)

References 21 publications

Supporting

Mentioning

216

Contrasting

Order By: Relevance

“…Increasingly, clinical practice is confronted with treatment of elderly patients with multiple comorbid diseases, for whom the risk for postoperative morbidity is high. Although various studies have identified risk factors for unfavorable outcome after colon resections [9][10][11], with similar results and test characteristics of their models as in the present study [11], the implications of these risk factors for elderly patients in 'real life' have not been elucidated. Our study, which is based on a nationwide population-based registry, shows that for otherwise healthy elderly patients, operative risk is only slightly increased, and similar after elective and nonelective resections.…”

Section: Discussionmentioning

confidence: 71%

Nonelective Colon Cancer Resections in Elderly Patients: Results from the Dutch Surgical Colorectal Audit

Kolfschoten¹,

Wouters

Gooiker³

et al. 2012

Dig Surg

View full text Add to dashboard Cite

Aims: The aim of the study was to assess which factors contribute to postoperative mortality, especially in elderly patients who undergo emergency colon cancer resections, using a nationwide population-based database. Methods: 6,161 patients (1,172 nonelective) who underwent a colon cancer resection in 2010 in the Netherlands were included. Risk factors for postoperative mortality were investigated using a multivariate logistic regression model for different age groups, elective and nonelective patients separately. Results: For both elective and nonelective patients, mortality risk increased with increasing age. For nonelective elderly patients (80+ years), each additional risk factor increased the mortality risk. For a nonelective patient of 80+ years with an American Society of Anesthesiologists score of III+ and a left hemicolectomy or extended resection, postoperative mortality rate was 41% compared with 7% in patients without additional risk factors. Conclusions: For elderly patients with two or more additional risk factors, a nonelective resection should be considered a high-risk procedure with a mortality risk of up to 41%. The results of this study could be used to adequately inform patient and family and should have consequences for composing an operative team.

show abstract

Section: Discussionmentioning

confidence: 71%

Nonelective Colon Cancer Resections in Elderly Patients: Results from the Dutch Surgical Colorectal Audit

Kolfschoten¹,

Wouters

Gooiker³

et al. 2012

Dig Surg

View full text Add to dashboard Cite

show abstract

“…[3][4][5] Colectomy accounts for 10% of general surgery operations in the American College of Surgeons' National Surgical Quality Improvement Program but for 25% of the complications, making it the most common cause of postoperative death and prolonged hospitalization. 4 These complications substantially increase the costs of surgical care for both hospitals and payors.…”

Section: Introductionmentioning

confidence: 99%

The personal financial burden of complications after colorectal cancer surgery

Regenbogen

Veenstra

Hawley

et al. 2014

Cancer

View full text Add to dashboard Cite

BACKGROUND:Patients with colorectal cancer (CRC) may suffer significant economic hardship during treatment. Complications are common after surgery for CRC and may exacerbate the financial burden of CRC even further. METHODS: Within a population-based survey of patients with stage III CRC, the authors investigated the effects of disease and treatment on personal finances and computed a composite measure of financial burden. Correlations were examined between components of financial burden and patientreported postoperative complications using chi-square analyses, and Mantel-Haenszel chi-square tend tests were used to evaluate correlations between composite financial burden scores and surgical complications, controlling for patient characteristics and other factors by using multivariable Poisson regression. RESULTS: Among 937 respondents, 224 (24%) reported complications after surgery. Those with complications had significantly higher composite financial burden (P <.001 for trend): they were more likely to spend savings (40% vs 31%; P 5.01), borrow or take loans (18% vs 11%; P 5.007), fail to make credit card payments (18% vs 11%; P 5.005), reduce spending for food or clothes (38% vs 27%; P 5.001), and decrease recreational activities (41% vs 33%; P 5.03). They took significantly longer to return to work (P 5.009) and were more likely to experience significant worry about finances (61% vs 52%; P 5.01). CONCLUSIONS: Complications after surgery for CRC result in significant personal financial consequences as well as morbidity. Financial stress impairs quality of life and may prevent adherence to recommended treatments. Therefore, patients who suffer complications may require not just additional clinical care but also economic support and services. Cancer 2014;120:3074-81.

show abstract

“…The proportion of patients with morbidity and mortality following colorectal surgery in the United States is estimated to be 24-29% and 1-4%, respectively [11,12,13,14]. The choice between observation and operation for polyps can be especially difficult among high-risk populations [15,16].…”

Section: Introductionmentioning

confidence: 99%

Postoperative Morbidity and Mortality among Veterans Health Administration Patients Undergoing Surgical Resection for Large Bowel Polyps (Bowel Resection for Polyps)

2013

View full text Add to dashboard Cite

Background: Large bowel polyps with malignant characteristics or those that are too large to remove colonoscopically may require bowel resection. Method: We performed a retrospective review of 126 Veterans Health Administration patients who underwent elective resections for colonoscopically unresectable colorectal polyps over a 10-year period. We evaluated the association of patient characteristics and operative management on the composite outcome of 30-day postoperative morbidity and mortality. Results: 98% of patients were males. Mean age was 65.1 years. Most patients had comorbidities, including cardiac or vascular disease (47.4%), diabetes mellitus (54%), and tobacco (41%) or alcohol (32.5%) use. The majority (85.7%) of patients were considered to be in American Society of Anesthesiologists (ASA) physical status classifications III and IV. 92% of resections were completed via laparotomy. Thirty-day postoperative morbidity and mortality occurred among 40 (31.7%) patients. Fifty-six patients (44.4%) had operative specimens with malignant features. The only comorbidity statistically associated with 30-day morbidity and mortality was body mass index >30. Conclusion: Approximately one third of patients had significant postoperative morbidity or mortality. Clinical pathways chosen to treat colonoscopically unresectable polyps should be tailored to patients' conditions and the characteristics of their colorectal lesions.

show abstract

Development of an American College of Surgeons National Surgery Quality Improvement Program: Morbidity and Mortality Risk Calculator for Colorectal Surgery

Cited by 333 publications

References 21 publications

Nonelective Colon Cancer Resections in Elderly Patients: Results from the Dutch Surgical Colorectal Audit

Nonelective Colon Cancer Resections in Elderly Patients: Results from the Dutch Surgical Colorectal Audit

The personal financial burden of complications after colorectal cancer surgery

Postoperative Morbidity and Mortality among Veterans Health Administration Patients Undergoing Surgical Resection for Large Bowel Polyps (Bowel Resection for Polyps)

Contact Info

Product

Resources

About