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Early postoperative mortality after surgery for rectal cancer in Sweden, 2000-2011
Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0002-0974-6373
Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
Örebro University Hospital. Department of Surgery.ORCID iD: 0000-0002-2350-5306
Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
2014 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 16, no 6, 426-432 p.Article in journal (Refereed) Published
Abstract [en]

Aim: Postoperative mortality has traditionally been defined as death within 30 days of surgery. Such mortality after rectal cancer resection has declined significantly during the last decades. However, it is possible that this decline can be explained merely by a shift towards an increase in 90-day mortality.

Method: A nationwide cohort study was based on data from the Swedish Colorectal Cancer Registry and the Swedish Patient Registry concerning patients who had undergone surgical resection for rectal cancer in 2000-2011. Unconditional logistic regression was used to calculate ORs with 95% CIs regarding mortality in different calendar periods (2000-2003, 2004-2007 and 2008-2011) in two different postoperative time periods (0-30 days and 31-90 days).

Results: Some 15,437 patients were included in this surgical cohort. Mortality within 30 days of surgery decreased from 2.1% in 2000-2003 to 1.6% in 2008-2011, whilst the corresponding mortality within the 31- to 90-day time window decreased from 2.1% to 1.4%. The adjusted risk of 30-day mortality in 2008-2011 was statistically significantly decreased compared with that in 2000-2003 (OR = 0.67; 95% CI: 0.48-0.93) and mortality in the 31- to 90-day time window was also reduced for 2008-2011 compared with 2000-2003 (OR = 0.71; 95% CI: 0.51-0.99).

Conclusion: This population-based, nationwide Swedish study indicates that postoperative mortality, as measured within 30 days and 31-90 days after surgery, has decreased with time. However, no relevant shift from earlier to later postoperative mortality was discerned.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014. Vol. 16, no 6, 426-432 p.
Keyword [en]
Anterior resection, Hartmann's procedure, abdominoperineal resection, colorectal, rectum
National Category
Surgery Gastroenterology and Hepatology
Research subject
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-35803DOI: 10.1111/codi.12572ISI: 000335940500009PubMedID: 24460574Scopus ID: 2-s2.0-84900490867OAI: oai:DiVA.org:oru-35803DiVA: diva2:741503
Note

Funding Agencies:

Cancer Research Foundation in Northern Sweden

Svenska Läkarsällskapet

Research Council Västernorrland County

Available from: 2014-08-28 Created: 2014-07-30 Last updated: 2017-10-18Bibliographically approved

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