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Adult and Elderly Risk Factors of Mortality in 23,614 Emergently Admitted Patients with Rectal or Rectosigmoid Junction Malignancy

Author

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  • Lior Levy

    (School of Medicine, New York Medical College, Valhalla, NY 10595, USA)

  • Abbas Smiley

    (Westchester Medical Center, New York Medical College, Valhalla, NY 10595, USA)

  • Rifat Latifi

    (Department of Surgery, University of Arizona, Tucson, AZ 85721, USA)

Abstract

Background: Colorectal cancer, among which are malignant neoplasms of the rectum and rectosigmoid junction, is the fourth most common cancer cause of death globally. The goal of this study was to evaluate independent predictors of in-hospital mortality in adult and elderly patients undergoing emergency admission for malignant neoplasm of the rectum and rectosigmoid junction. Methods: Demographic and clinical data were obtained from the National Inpatient Sample (NIS), 2005–2014, to evaluate adult (age 18–64 years) and elderly (65+ years) patients with malignant neoplasm of the rectum and rectosigmoid junction who underwent emergency surgery. A multivariable logistic regression model with backward elimination process was used to identify the association of predictors and in-hospital mortality. Results: A total of 10,918 non-elderly adult and 12,696 elderly patients were included in this study. Their mean (standard deviation (SD)) age was 53 (8.5) and 77.5 (8) years, respectively. The odds ratios (95% confidence interval, P-value) of some of the pertinent risk factors for mortality for operated adults were 1.04 for time to operation (95%CI: 1.02–1.07, p < 0.001), 2.83 for respiratory diseases (95%CI: 2.02–3.98), and 1.93 for cardiac disease (95%CI: 1.39–2.70), among others. Hospital length of stay was a significant risk factor as well for elderly patients—OR: 1.02 (95%CI: 1.01–1.03, p = 0.002). Conclusions: In adult patients who underwent an operation, time to operation, respiratory diseases, and cardiac disease were some of the main risk factors of mortality. In patients who did not undergo a surgical procedure, malignant neoplasm of the rectosigmoid junction, respiratory disease, and fluid and electrolyte disorders were risk factors of mortality. In this patient group, hospital length of stay was only significant for elderly patients.

Suggested Citation

  • Lior Levy & Abbas Smiley & Rifat Latifi, 2022. "Adult and Elderly Risk Factors of Mortality in 23,614 Emergently Admitted Patients with Rectal or Rectosigmoid Junction Malignancy," IJERPH, MDPI, vol. 19(15), pages 1-18, July.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:15:p:9203-:d:873592
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    References listed on IDEAS

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    1. Luigi Laino & Marco Cicciù & Luca Fiorillo & Salvatore Crimi & Alberto Bianchi & Giulia Amoroso & Ines Paola Monte & Alan Scott Herford & Gabriele Cervino, 2019. "Surgical Risk on Patients with Coagulopathies: Guidelines on Hemophiliac Patients for Oro-Maxillofacial Surgery," IJERPH, MDPI, vol. 16(8), pages 1-12, April.
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    Cited by:

    1. Alexander Ladinsky & Abbas Smiley & Rifat Latifi, 2023. "Elderly Patients Managed Non-Operatively with Abscesses of the Anorectal Region Have Five Times Higher Rate of Mortality Compared to Non-Elderly," IJERPH, MDPI, vol. 20(7), pages 1-19, April.
    2. Saral Patel & Abbas Smiley & Cailan Feingold & Bardia Khandehroo & Agon Kajmolli & Rifat Latifi, 2022. "Chances of Mortality Are 3.5-Times Greater in Elderly Patients with Umbilical Hernia Than in Adult Patients: An Analysis of 21,242 Patients," IJERPH, MDPI, vol. 19(16), pages 1-17, August.
    3. Maksat Idris & Abbas Smiley & Saral Patel & Rifat Latifi, 2022. "Risk Factors for Mortality in Emergently Admitted Patients with Acute Gastric Ulcer: An Analysis of 15,538 Patients in National Inpatient Sample, 2005–2014," IJERPH, MDPI, vol. 19(23), pages 1-23, December.

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