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Factors Impacting Mortality In Turkish Octogenarian and Nonagenarian Patients Who Underwent Colorectal Surgery

Author: Cengiz Ceylan, Serhat Ocakli, Felat Akinci, Erdinc Cetinkaya, Ibrahim Agackiran, Tezcan Akin, Sadettin Er

Category: JMSR Surgery


Background & objective: Due to their physiological conditions, the postoperative mortality rates of elderly patients are higher compared to other age groups, albeit the postoperative care and intensive care conditions are better than in the past. In this retrospective study, it was aimed to present a model to predict mortality and factors affecting mortality in this patient group who underwent colorectal surgery. Material & Methods: The population of octogenarian and nonagenarian patients who were operated for colorectal surgery in our clinic between 2020 and 2021 were included in the study. Patients' age, gender, albumin, lymphocyte, monocytes, lymphocyte-monocyte ratio (LMR), prognostic nutritional index (PNI), delta neutrophil index (DNI), Charlson comorbidity index (CCI), length of hospital stay, modified systemic inflammatory score (mSIS)) values, operation type (emergency/ elective), operation classification (minor/ moderate/ major/ complex major), anesthesia type (general/ epidural), and contamination status (clean/ clean-contaminated/ contaminated/ dirty or infected) were obtained from the hospital system. Results: Case status, operation type, contamination status, DNI, duration of hospitalization, mSIS variables were statistically significant in univariate regression analyses. However, in multivariate regression analyses, DNI of ? 0.05 (p< 0.015; OR 3.984, 95%CI 1.302- 12.195) and contamination status (p< 0.038; OR 13,047, 95%Cl 1,150- 148,087) were found to be independent risk factors affecting postoperative mortality. Conclusion: In the geriatric patient population undergoing colorectal surgery, DNI and contamination of the surgical field are two important factors affecting mortality. We think that the mortality estimation model created for this patient population will also help physicians for the postoperative period of the patients.

Keywords: Colorectal Surgery, Mortality, Model, Nonagenarian, Octogenerian, Turkey

DOI: 10.46327/msrjg.1.000000000000228



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