Outcome of emergency colorectal cancer admissions is determined primarily by physical status

Abstract

A retrospective cohort study of 206 consecutive patients with colorectal
cancer presenting to three general surgeons in the University Hospital, Kuala Lumpur
over a 3-year period is reported. In all, 184 patients had an operation and are grouped
according to whether their operation was within 24 hours of admission (n=16), more
than 24 hours after admission (n=38), or elective (n=130). Operative mortalities for these
groups were 15.9%, 15.2% and 6.5%, respectively, significantly higher in both the emer-
gency groups. Delayed surgery to allow complete resuscitation did not improve the
operative mortality when compared with those patients having urgent surgery. Both
groups of emergency patients, delayed (27%) and urgent (19%), showed poorer 5~year
survival than the electively treated patients (36%), many dying of non-cancer causes.
Patients who undergo emergency surgery for colorectal carcinoma are more likely to
be in poorer physical condition than the patients undergoing elective surgery for the
same condition. It appears that the physical status is the principal determinant of out-
come after emergency colorectal surgery rather than any other factor.