COPD is a clear risk factor for increased use of resources and adverse outcomes in patients undergoing intervention for colorectal cancer : a nationwide study in Spain
Baré i Mañas, Marisa (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Montón, Concepción (Research Network on Health Services in Chronic Diseases - REDISSEC)
Mora, Laura (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Redondo, Maximino (Research Network on Health Services in Chronic Diseases - REDISSEC)
Pont, Marina (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Escobar, Antonio (Research Network on Health Services in Chronic Diseases - REDISSEC)
Sarasqueta, Cristina (Research Network on Health Services in Chronic Diseases - REDISSEC)
Fernández de Larrea, Nerea (Centro Nacional de Epidemiología (Espanya))
Briones, Eduardo (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Quintana López, José María (Research Network on Health Services in Chronic Diseases - REDISSEC)
Universitat Autònoma de Barcelona

Fecha:	2017
Resumen:	We hypothesized that patients undergoing surgery for colorectal cancer (CRC) with COPD as a comorbidity would consume more resources and have worse in-hospital outcomes than similar patients without COPD. Therefore, we compared different aspects of the care process and short-term outcomes in patients undergoing surgery for CRC, with and without COPD. This was a prospective study and it included patients from 22 hospitals located in Spain - 472 patients with COPD and 2,276 patients without COPD undergoing surgery for CRC. Clinical variables, postintervention intensive care unit (ICU) admission, use of invasive mechanical ventilation, and postintervention antibiotic treatment or blood transfusion were compared between the two groups. The reintervention rate, presence and type of complications, length of stay, and in-hospital mortality were also estimated. Hazard ratio (HR) for hospital mortality was estimated by Cox regression models. COPD was associated with higher rates of in-hospital complications, ICU admission, antibiotic treatment, reinterventions, and mortality. Moreover, after adjusting for other factors, COPD remained clearly associated with higher and earlier in-hospital mortality. To reduce in-hospital morbidity and mortality in patients undergoing surgery for CRC and with COPD as a comorbidity, several aspects of perioperative management should be optimized and attention should be given to the usual comorbidities in these patients.
Ayudas:	Instituto de Salud Carlos III PS09-00314 Instituto de Salud Carlos III PS09-00910 Instituto de Salud Carlos III PS09-00746 Instituto de Salud Carlos III PS09-00805 Instituto de Salud Carlos III PI09-90460 Instituto de Salud Carlos III PI09-90490 Instituto de Salud Carlos III PI09-90397 Instituto de Salud Carlos III PI09-90453 Instituto de Salud Carlos III PI09-90441 Instituto de Salud Carlos III RD12-0001-0007
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	COPD ; Colorectal cancer ; In-hospital mortality ; Reintervention ; Complications
Publicado en:	International journal of COPD, Vol. 12 (april 2017) , p. 1233-1241, ISSN 1178-2005

DOI: 10.2147/COPD.S130377
PMID: 28461746

9 p, 587.0 KB

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