Mortality after Colon Surgery: The Value of a Mortality Registration System

Abstract

Background/Aims: Postoperative mortality after colon surgery is relatively infrequent. In order to evaluate the quality of colon surgery, post-mortem evaluation is useful. This study was performed to determine the value of a mortality register used at the Department of Surgery of the Red Cross Hospital. Methods: From 1991 to 2000, 882 colon resections were performed for both malignant and benign disorders, including elective and emergency surgery. Permission for autopsy was asked routinely. All cases were reviewed and categorized in a multidisciplinary meeting. Any discrepancy between the clinical and post-mortem diagnosis was determined by a pathologist. Results: The mortality rate of colon surgery was 8.0% (n = 71), 23% for emergency surgery and 6% for elective surgery (p < 0.001). For patients under 70 years of age the mortality rate was 4.3%, for patients over 70 years of age 11.2% (p < 0.001). Autopsy was performed in 62% (n = 44) of the patients. Discrepancy between clinical and post-mortem findings was documented in 14%. Conclusion: Postoperative mortality after colon surgery is influenced by the timing of surgery (elective or emergency procedure) and the age of the patient. A discrepancy of 14% between clinical cause of death and post-mortem cause of death justifies the need for obtaining autopsy in this type of surgery.

Emergency Left Colon Resection for Acute Perforation. Primary Anastomosis or Hartmann’s Procedure? A Case‐matched Control Study

“…The most important prognostic factors influencing morbidity and mortality are age, ASA score, obesity, the need for an emergency operation, and the severity of peritonitis (Hinchey stage or MPI index) [15,25,[29][30][31]. In a recently published multivariate analysis of 156 patients, ASA score and preoperative organ failure were significantly associated with increased mortality [32].…”

Evaluation of P-POSSUM in Surgery for Obstructing Colorectal Cancer and Correlation of the Predicted Mortality With Different Surgical Options

“…Although operative mortality is low in patients operated on under an elective setting, the mortality remains high in those who have emergency surgery. [11][12][13] Emergency surgery for obstruction accounts for approximately 15 to 25 percent of all operations for primary colorectal cancer. 14 These patients are usually elderly with underlying medical illnesses.…”

Differences in colorectal cancer surgery outcomes in Serbia: Hospitals in organized colorectal cancer screening and other hospitals

“…It is well known that mortality of urgent colorectal operations is much higher compared to elective surgery and varies from 15-25%. 16,17 There is no doubt that the numerous factors that contribute to the postoperative mortality need to be taken into the consideration in the future research. Some used scoring systems in order to predict more accurately postoperative mortality.…”