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PREHABILITATION AND THE ‘PERIOPERATIVE DOCTOR’

▸ Iversen LH, Bülow S, Christensen IJ, Laurberg S, . Postoperative medical complications are the main cause of early death after emergency surgery for colonic cancer. Br J Surg 2008;95:1012–9.

There is an increasing realisation that elective surgical outcomes can be positively influenced by risk stratification and perioperative optimisation. The concept of prehabilitation and the emergence of the perioperative doctor both aim to reduce morbidity and mortality. Few studies have evaluated risk factors related to early death following emergency surgery for colonic cancer. The authors’ aim in this study was to identify risk factors for death within 30 days after such surgery. A total of 2157 patients who underwent emergency treatment for colonic cancer from May 2001 to December 2005 were identified from the national colorectal cancer registry. Thirty-day mortality rates were calculated and risk factors for early death were identified using logistic regression analysis. The overall 30-day mortality rate was 22.1%. The strongest risk factor for early death was postoperative medical complications (cardiopulmonary, renal, thromboembolic and infectious), with an odds ratio of 11.7 (95% CI 8.8 to 15.5). Such complications occurred …

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    BMJ Publishing Group Ltd and British Society of Gastroenterology