Objective: To evaluate predictors and burden of emergency colorectal cancer resection (E-CCR).
Study design: Cross-sectional study of 127,975 discharges of patients with colorectal cancer undergoing resection.
Methods: We used the 2002 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project; E-CCR was identified based on the presence of bowel perforation, peritonitis, or obstruction. Bivariate and multilevel multivariable analyses were used to study the association between E-CCR and patient attributes, including demographics, insurance status, comorbidities, health status, and teaching hospital status.
Results: Among younger patients, Medicaid enrollees (adjusted odds ratio [AOR], 2.08; 95% confidence interval [CI], 1.68-2.58) and the uninsured [AOR], 2.62; 95% CI, 2.05-3.34) were at higher risk for E-CCR. Among older patients, those dually eligible for Medicare and Medicaid were at higher risk for E-CCR (AOR, 1.37; 95% CI, 1.11-1.70). Emergency colorectal cancer resection was associated with greater than 3-fold increased in-hospital mortality, 54 979 (95% CI, 38 731-71 226) excess hospital days as a result of longer lengths of stay, and more than 250 million dollars (95% CI, 180 million-334 million dollars) in hospital charges.
Conclusion: Targeted interventions to increase colorectal cancer screening in vulnerable subgroups of the population would reduce the substantial patient and societal burden associated with failure to screen.