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Title: 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.
Authors: Baré, Marisa
Montón, Concepción
Mora, Laura
Redondo, Maximino
Pont, Marina
Escobar, Antonio
Sarasqueta, Cristina
Fernández de Larrea, Nerea
Briones, Eduardo
Quintana, Jose Maria
Keywords: COPD;colorectal cancer;complications;in-hospital mortality;reintervention
metadata.dc.subject.mesh: Aged
Aged, 80 and over
Anti-Bacterial Agents
Blood Transfusion
Chi-Square Distribution
Colorectal Neoplasms
Health Resources
Hospital Mortality
Intensive Care Units
Kaplan-Meier Estimate
Length of Stay
Logistic Models
Patient Admission
Postoperative Complications
Proportional Hazards Models
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Respiration, Artificial
Risk Factors
Time Factors
Treatment Outcome
Issue Date: 21-Apr-2017
Abstract: 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.
metadata.dc.identifier.doi: 10.2147/COPD.S130377
Appears in Collections:Producción 2020

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