Risk factors for postoperative complications after colorectal surgery in patients aged ≥ 80 years: A multicenter retrospective study.

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.