Results and postoperative quality of life in patients greater than 80 years old after colorectal surgery

D. Schraffl, R. Joos, C. Hänsli, P. Villiger

Objective

There are several challenges in surgical treatment of colorectal diseases in patients over 80. Our goal was to determine outcomes after colorectal surgery with postoperative quality of life (evaluated according to SF-36) and mortality.

Methods

This study includes postoperative colorectal surgery patients over 80 years after between January 1, 2010 and December 31, 2013. Data was taken from our hospital database, general practitioner and patient interviews. We included curative and palliative as well as elective and emergency interventions.

Results

Eighty-four patients (39 male, 45 female, age between 80 and 99 years, mean age 86,9 +/- 4,6 years) were studied. Median follow up was 17 months. Four (4,7%) patients were lost to follow up. The overall mortality rate was 32,1%. The 30-day mortality rate of all patients was 11,9%. Nine of 10 patients that died within the first 30 days had an emergency surgery. Based on SF-36 results, most of surviving patients had an improvement in postoperative quality of life. Patients without benefit most often claimed aggravation of pre-existing defecation problems. The correlation between ASA score and functional renal impairment mortality was highest in first 30 days.

Table 1: Change in quality of life after colorectal surgery

Conclusion

Operation in patients over 80 years is safe. Emergency surgery has a much higher mortality rate than elective surgery. Risk factors include a high ASA score and functional renal impairment. Postoperative survivors demonstrated superior SF-36 scores and improved quality of life.