Ramzi Amri|Liliana Bordeianou|Patricia Sylla|David L. Berger
Colon cancer surgery following emergency presentation: effects on admission and stage-adjusted outcomes
Massachusetts General Hospital|Harvard University|Massachusetts General Hospital|Harvard University|Massachusetts General Hospital|Harvard University|Massachusetts General Hospital|Harvard University
background emergency presentation colon cancer intuitively related advanced disease measured effect outcomes surgically treated colon cancer methods retrospective cohort 1071 surgical colon cancer patients 2004 2011 102 emergency cases requiring surgery within index admission analyzed results emergency patients required longer surgeries median 141 vs 124 minutes p 04 longer median admissions 8 vs 5 p 001 readmissions 127 vs 71 p 040 perioperative mortality 78 vs 8 p 001 surgical pathology displayed higher rates nodepositive disease 566 vs 386 p 001 extramural vascular invasion 396 vs 291 p 021 metastatic disease 196 vs 8 p 001 consequently adjusting staging emergency presentations considerably higher mortality odds ratio 207 p 003 shorter diseasefree survival hazard ratio 139 p 042 conclusions emergency presentation stageindependent poor prognostic factor associated aggressive tumor biology resulting longer surgeries admissions frequent readmissions worsening outcomes increasing healthcare costs