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Emergency surgery for colonic cancer in a defined population
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. (Gastrointestinal Surgery)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. (Gastrointestinal Surgery)
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2005 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 92, no 1, 94-100 p.Article in journal (Refereed) Published
Abstract [en]

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.
Keyword [en]
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
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-71347DOI: 10.1002/bjs.4780PubMedID: 15521083OAI: oai:DiVA.org:uu-71347DiVA: diva2:99258
Available from: 2006-06-26 Created: 2006-06-26 Last updated: 2017-11-21Bibliographically approved

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Jestin, PiaPåhlman, LarsGlimelius, BengtGunnarsson, U.

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Jestin, PiaPåhlman, LarsGlimelius, BengtGunnarsson, U.
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Department of Surgical SciencesDepartment of Oncology, Radiology and Clinical Immunology
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British Journal of Surgery
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