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Colon and Rectal Surgery, Public Health Sciences
Henry Ford Health System
Introduction: There are limited data regarding surgical outcomes for elderly patients with Ulcerative Colitis, and we sought to examine the post operative outcomes in this population.
Methods: The ACS NSQIP was queried for all patients with a diagnosis of ulcerative colitis and compared elderly patients (those aged 65 and older) to younger patients under age 65. Univariate and multivariate logistic regression was done to evaluate differences in morbidity and mortality rates.
Results: 2,699 patients were analyzed, of which 493 (18.3%) were defined as elderly. Elderly patients had more comorbidities compared to younger patients but were less likely to be on preoperative steroids (47.1% vs 74.2%, p<0.0001). Elderly patients had a higher proportion of emergent cases (27.6% vs 8.2%, p<0.0001) and an average 3 day longer hospital stay, (p<0.0001). There were no significant differences in the rates of anastomotic leak, surgical site infections or 30-day readmission. Elderly patients had a higher rate of morbidity (47.3% vs 26.8%, p<0.0001) and mortality (8.9% vs 1.2%, p<0.0001). Multivariate analysis showed elderly patients had significantly increased odds for morbidity (OR 2.45, 95% CI: 2.00-2.99, p<0.0001) and 30-day mortality (OR 7.91, 95% CI: 4.85-12.91, p<0.001). Preoperative sepsis significantly increased the risk of morbidity (OR 3.457, 95% CI: 2.27-5.26, p <0.0001) and mortality (OR 3.11, 95% CI: 1.48-6.57, p<0.003).
Conclusions: Elderly patients with Ulcerative Colitis that undergo a colectomy are at increased risk for both morbidity and mortality. Optimizing these patients may reduce the risk, but further prospective trials are warranted to further elucidate the ideal optimization strategies.
Dobesh, Kaitlyn; Kandagatla, Pridvi; Tang, Amy; Reickert, Craig; and Stefanou, Amalia, "COLECTOMY OUTCOMES IN PATIENTS OVER 65 WITH ULCERATION COLITIS" (2021). Surgery & Anesthesia Research Celebration Day 2021. 1.