Abstract
BACKGROUND: The goal of surgery for colorectal cancer is cure. Unfortunately post-operative mortality occurs. This study aims to identify co-morbidity and causes of mortality in the post-operative period in relation to direct technical complications of surgery. METHODS: All consecutive patients who underwent surgery for colorectal cancer were included. Co-morbidity was determined via the Charlson co-morbidity score. The post-operative course was studied and cause of death within 30 days was determined. Patients were divided in two groups: group 1 died within 30 days after surgery and group 2 survived for longer than 30 days. RESULTS: Twenty three out of 333 patients (6.9%) with colon cancer and 6 out of 112 (5.3%) with rectal cancer died in the post-operative period. Patients in group 1 were significantly older than patients in group 2 (P<0.001). Patients in group 1 with colon cancer also significantly had more often a higher stage of cancer (P=0.03). The Charlson co-morbidity score for patients with colon cancer in group 1 was mean 5.17 (SD 1.57, range, 1-8), and for rectal cancer mean 4.83 (SD 2.32, range, 2-7). There was no difference in Charlson co-morbidity score when patients from groups 1 and 2 were compared. In group 1, 13 (44%) died as a direct consequence of technical surgical complications. Sixteen patients died due to complications because of pre-existing co-morbidity. CONCLUSIONS: Post-operative mortality very often is the direct result of pre-existing co-morbidity and not always the direct result of the surgical procedure.