Emergency surgery for colonic cancer in a defined population

Jestin, Pia (author): Uppsala universitet,Institutionen för kirurgiska vetenskaper,Gastrointestinal Surgery,Department of Surgical Sciences, Federation of County Councils, Stockholm

Nilsson, J. (author)

Heurgren, M. (author)

Påhlman, Lars (author): Uppsala universitet,Institutionen för kirurgiska vetenskaper,Gastrointestinal Surgery

Glimelius, Bengt (author): Karolinska Institutet,Uppsala universitet,Institutionen för onkologi, radiologi och klinisk immunologi,Gastrointestinal oncology

Gunnarsson, U. (author): Uppsala universitet,Institutionen för kirurgiska vetenskaper,Gastrointestinal Surgery,Department of Surgical Sciences, University Hospital, Uppsala, Sweden

(creator_code:org_t)

2004-11-01
2005
English.
In: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 92:1, s. 94-100

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Abstract Subject headings

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.

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

By the author/editor: Jestin, Pia; Nilsson, J.; Heurgren, M.; Påhlman, Lars; Glimelius, Bengt; Gunnarsson, U.

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Gastroenterology ...

By the university: Uppsala University; Umeå University; Karolinska Institutet

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