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Post-discharge complications in frail older patients after surgery for colorectal cancer

Ommundsen, Nina; Nesbakken, Arild; Wyller, Torgeir Bruun; Skovlund, Eva; Bakka, Arne Olav; Jordhøy, Marit Slaaen; Rostoft, Siri
Journal article, Peer reviewed
Published version
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Ommundsen (Locked)
URI
http://hdl.handle.net/11250/2597964
Date
2018
Metadata
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  • Institutt for samfunnsmedisin og sykepleie [1724]
  • Publikasjoner fra CRIStin - NTNU [19961]
Original version
European Journal of Surgical Oncology. 2018, 44 (10), 1542-1547.   10.1016/j.ejso.2018.06.024
Abstract
Background

The incidence of postoperative complications after colorectal cancer surgery varies between publications. Complications occurring after discharge from hospital are often not reported. The aims of this study were to investigate the proportion of frail older colorectal cancer patients who developed complications only after discharge, the severity of post-discharge complications, and the time point at which the most frequent complications occurred.

Methods

Patients were included if they were 65 years and older, screened positively for frailty and were scheduled for colorectal cancer surgery. Included patients were followed prospectively both in hospital and after discharge for 30 days after surgery, and complications were graded according to the Clavien-Dindo classification.

Results

We included 114 patients. Median age was 79 years. Twenty-two patients (19%) were discharged without complications, but developed complications after discharge. These patients had shorter length of stay (6.5 versus 10 days), were more often discharged to their own home without assistance, and had higher 5-year survival (76% vs 54%) than patients who developed complications in hospital. Post-discharge complications were most frequently grade II. The most common types of complications that occurred late in the postoperative course were urinary tract infections and superficial surgical site infections.

Conclusions

Complications after colorectal cancer surgery in frail older patients frequently arise after discharge from hospital. Doctors should be aware of this and inform their patients. This is increasingly important as length of stay after surgery decreases. When complications are used as a quality measure, it should be clear whether only in-hospital complications are registered.
Publisher
Elsevier
Journal
European Journal of Surgical Oncology

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