Emergency surgery for colonic cancer in a defined population
2005 (English)In: British Journal of Surgery, ISSN 0007-1323, Vol. 92, no 1, 94-100 p.Article in journal (Refereed) Published
BACKGROUND: The aim of this study was to identify risk factors in emergency surgery for colonic cancer in a large population and to investigate the economic impact of such surgery. METHODS: Data from the colonic cancer registry (1997-2001) of the Uppsala/Orebro Regional Oncological Centre were analysed and classified by hospital category. Some 3259 patients were included; 806 had an emergency and 2453 an elective procedure. Data for calculating effects on health economy were derived from a national case-costing register. RESULTS: Patients who had emergency surgery had more advanced tumours and a lower survival rate than those who had an elective procedure (5-year survival rate 29.8 versus 52.4 per cent; P < 0.001). There was a stage-specific difference in survival, with poorer survival both for patients with stage I and II tumours and for those with stage III tumours after emergency compared with elective surgery (P < 0.001). Emergency surgery was associated with a longer hospital stay (mean 18.0 versus 10.0 days; P < 0.001) and higher costs (relative cost 1.5 (95 per cent confidence interval 1.4 to 1.6)) compared with elective surgery. The duration of hospital stay was the strongest determinant of cost (r(2) = 0.52, P < 0.001). CONCLUSION: Emergency surgery for colonic cancer is associated with a stage-specific increase in mortality rate.
Place, publisher, year, edition, pages
2005. Vol. 92, no 1, 94-100 p.
Adolescent, Adult, Aged, Aged; 80 and over, Child, Colonic Neoplasms/economics/epidemiology/*surgery, Cost of Illness, Emergency Treatment/*economics/mortality, Female, Humans, Length of Stay/economics, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Prognosis, Prospective Studies, Registries, Research Support; Non-U.S. Gov't, Risk Factors, Surgical Procedures; Elective/economics/mortality, Survival Analysis, Sweden/epidemiology
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-71347DOI: 10.1002/bjs.4780PubMedID: 15521083OAI: oai:DiVA.org:uu-71347DiVA: diva2:99258