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14.04.2017 | Original Article | Ausgabe 6/2017

International Journal of Colorectal Disease 6/2017

Impact of postoperative complications on readmission and long-term survival in patients following surgery for colorectal cancer

Zeitschrift:
International Journal of Colorectal Disease > Ausgabe 6/2017
Autoren:
Ksenija Slankamenac, Maja Slankamenac, Andrea Schlegel, Antonio Nocito, Andreas Rickenbacher, Pierre-Alain Clavien, Matthias Turina
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00384-017-2811-y) contains supplementary material, which is available to authorized users.

Abstract

Purpose

It is well known that specific postoperative complications such as stroke influence readmissions and overall survival (OS) after surgery for colorectal cancer (CRC). Whether overall hospital morbidity is associated with increased risk of readmission and poorer long-term survival is unknown. New tools are available to accurately quantify overall morbidity, such as the comprehensive complication index (CCI). The aim is to evaluate the impact of complications on readmission and overall survival (OS) in patients operated for colorectal cancer.

Methods

Postoperative complications of patients undergoing surgery for CRC were assessed over a 5-year period using the Clavien-Dindo classification, and overall morbidity was assessed by using the CCI. Individual scores were analyzed regarding their association with readmission and OS by using the multivariate logistic and Cox proportional-hazards regression analysis, respectively.

Results

Two hundred eighty-four patients were operated for CRC, of which 22 (8%) were readmitted. One hundred five patients (37%) developed at least one postoperative complication during the hospital stay. While single complications or the use of severe complication only (grade ≥IIIb) was not associated with readmission, overall morbidity (CCI) predicted readmission (OR 1.02 (95% CI 1.0–1.04), p = 0.044). Similarly, morbidity assessed by the CCI had a significant negative predictive value on OS, e.g., patients with a CCI of 20 were 22% more likely to die within a 5-year follow-up, when compared to patients with a CCI of 10 (p = 0.022).

Conclusions

Overall combined morbidity as assessed by the CCI leads to more frequent readmission, and is associated with poorer long-term survival after surgery for CRC.

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Zusatzmaterial
ESM 1 (PDF 17 kb)
384_2017_2811_MOESM1_ESM.pdf
ESM 2 (PDF 14 kb)
384_2017_2811_MOESM2_ESM.pdf
Literatur
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