People over 80, especially, had greater need for post-op emergency care, researchers say
THURSDAY, April 10, 2014 (HealthDay News) -- Patients older than 65 are more likely to die and have more complications after colon cancer surgery than younger patients, a new study finds.
Researchers led by Dr. Mehraneh Jafari of the University of California, Irvine, School of Medicine examined data on more than 1 million patients, aged 45 and older, in the United States who had undergone colon cancer surgery between 2001 and 2010.
Nearly 64 percent of the patients were 65 and older and more than 22 percent were 80 and older, the researchers noted.
Patients 85 and older were 70 percent more likely to require urgent hospital admission after the surgery than those younger than 65, Jafari's team reported April 9 in the online issue of JAMA Surgery.
Patients 65 and older had higher death and complication rates than younger patients. The researchers also found that the average hospital stay was 2.5 days longer and the average hospital charge was nearly $9,500 more for patients 80 and older, compared to those younger than 65.
There was some good news, however: During the study period, the total number of colon cancer surgeries per year fell 5 percent in the general population and 7 percent among elderly people, the study found. Colon cancer death rates in all age groups also decreased.
Two colon cancer experts said the findings weren't surprising, since older patients tend to have more post-op issues than younger patients.
"While it comes as no surprise that elderly patients with associated medical problems are at a higher risk for surgical procedures, it is important to note that the overall death rate improved over the 10 years of the study," said Dr. Jerald Wishner, medical director of the Colorectal Surgery Program at Northern Westchester Hospital in Mount Kisco, N.Y.
He said that one of the study's "more concerning points" was the increased need for emergency admission to the hospital for older patients who had undergone colon surgeries, and the fact that fewer of these patients had undergone minimally invasive surgeries. If those issues could be addressed, "deaths and hospital costs could all be reduced in these high-risk patients," Wishner said.
Dr. Alex Jenny Ky is a colorectal surgeon at The Mount Sinai Hospital in New York City. She said that, despite the study findings, some older patients "do very well, if not even better, than some younger patients."
Ky said that, "in general, it's important for patients to evaluate who is performing the surgery -- is it a general surgeon or board-certified colon and rectal surgeon? "
The finding that there was an overall drop in the number of colon surgeries performed didn't surprise Ky, either.
"[Fewer] surgeries are performed for cancer across the board because we are better about screening," she said. "For example, polyps are now removed before they become cancerous. The bottom line is it is crucial to get screened, and if cancer is detected, to have surgery."
The U.S. National Cancer Institute has more about colon cancer treatment (http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page4#Keypoint17 ).
SOURCES: Alex Jenny Ky, M.D., colorectal surgeon, division of colon and rectal surgery, department of surgery, The Mount Sinai Hospital, New York City; Jerald Wishner, co-director, Institute for Robotic and Minimally Invasive Surgery, and medical director, Colorectal Surgery Program, Northern Westchester Hospital, Mount Kisco, N.Y.; JAMA Surgery, news release, April 9, 2014