Postoperative 30-day mortality following surgical resection for colorectal cancer in veterans: changes in the right direction

Dig Dis Sci. 2005 Sep;50(9):1722-8. doi: 10.1007/s10620-005-2925-x.


Temporal changes in short-term mortality following surgery for colorectal cancer (CRC) are unknown. We examined temporal changes in 30-day postoperative mortality, as well as changes in preoperative and postoperative disorders that could contribute to 30-day mortality. Using national Veterans Administration (VA) administrative data, we identified patients with CRC during 1987-2000 who received surgical resection. Cox proportional hazards models were used to evaluate the association between the risk of 30-day mortality and year of surgical resection, while adjusting for several preoperative disorders, disease comorbidity, as well as hospital surgical volume. A total of 32,621 patients were identified. The 30-day postoperative mortality declined from 4.7% during 1987-1988 to 3.9% during 1998-2000. Patients who received surgical resection during 1992-1994, 1995-1997, and 1998-2000 had a 14, 14, and 27% lower adjusted risk of 30-day mortality, respectively, compared with those resected in 1987-1988. Preoperative disorders associated with increased mortality included chronic pulmonary disease, congestive heart failure, diabetes, hemiplegia/paraplegia, moderate/severe liver disease, and renal disease. Significant declines were observed in several postoperative disorders including anesthesia complications and thromboembolism. An improvement in 30-day postoperative mortality following surgical resection for CRC was observed. Declining preoperative and postoperative disorders, as well as improvements in surgical care, could partly explain these findings.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / mortality*
  • Colorectal Neoplasms / surgery*
  • Digestive System Surgical Procedures / adverse effects*
  • Digestive System Surgical Procedures / mortality*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mortality / trends
  • Postoperative Complications / mortality*
  • Quality of Health Care
  • Retrospective Studies
  • Risk Factors
  • Veterans*