Risk factors associated with morbidity and mortality in emergency colorectal cancer resections.

BACKGROUND

Despite efforts toward early diagnosis, approximately 25% of patients with colorectal cancer are still operated on under emergency conditions. The aim of this study was to investigate the risk factors associated with morbidity and mortality in emergency colorectal cancer resections.

METHODS

Emergency colorectal cancer resections performed at a single center were included in this retrospective study. Baseline, operative, and tumor-related data were examined. Morbidity was defined as a complication of Clavien Dindo grade ≥3. Risk factors for both morbidity and mortality were evaluated using univariate analyses and multivariable logistic regression.

RESULTS

The study included 188 patients, of whom 119 (63.3%) were men. In the multivariate analysis, factors associated with increased morbidity risk were age (odds ratio [OR]=3.02, p=0.009), American Society of Anesthesiologists (ASA) score (OR=2.04, p=0.049), duration of surgery (OR=1.01, p=0.001), and presence of perforation (OR=3.24, p=0.004). Multivariate analysis for mortality demonstrated significant effects of age (OR=3.23, p=0.017), ASA score (OR=5.92, p=0.009), duration of surgery (OR=1.01, p=0.007), and presence of perforation (OR=3.01, p=0.013).

CONCLUSION

This study highlights several key risk factors-including advanced age (≥70 years), higher ASA scores (≥3), longer operative times, and the presence of perforation-that significantly impact morbidity and mortality in emergency colorectal cancer resections. Early recognition of these factors may improve risk stratification and guide more effective perioperative care strategies for high-risk patients.