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Early postoperative mortality after surgery for rectal cancer in Sweden 2000-2011
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
Department of Surgery, Örebro University Hospital, Örebro, Sweden.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
2014 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 16, no 6, 426-432 p.Article in journal (Refereed) Published
Abstract [en]

AIM: Postoperative mortality has traditionally been defined as death within 30 days of surgery. Such mortality after rectal cancer resection has declined significantly during the last decades. It is, however, possible that this decline can be explained merely by a shift towards an increase in 90-day mortality.

METHOD: A nationwide cohort study was based on data from the Swedish Colorectal Cancer Registry and the Swedish Patient Registry concerning patients who had undergone surgical resection for rectal cancer in 2000-2011. Unconditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) regarding mortality in different calendar periods (2000-2003, 2004-2007 and 2008-2011) in two different postoperative time windows: 0 to 30 days and 31 to 90 days.

RESULTS: Some 15,473 patients were included in this surgical cohort. Mortality within 30 days of surgery decreased from 2.1 to 1.6% between 2000-2003 and 2008-2011, while the corresponding mortality within 31 to 90 days decreased from 2.1 to 1.4%. The adjusted risk of 30-day mortality in the late period was statistically significantly decreased compared to the early period (OR 0.67; 95% CI 0.48-0.93), while the mortality from 31 to 90 days was also reduced (OR 0.71; 95% CI 0.51-0.99).

CONCLUSION: This population-based, nationwide Swedish study indicates that postoperative mortality as measured within 30 days and 31 to 90 days after surgery has decreased with time. However, no relevant shift from earlier to later postoperative mortality was discerned. 

Place, publisher, year, edition, pages
John Wiley & Sons, 2014. Vol. 16, no 6, 426-432 p.
Keyword [en]
anterior resection, Hartmann's procedure, abdominoperineal resection, colorectal, rectum
National Category
Surgery
Identifiers
URN: urn:nbn:se:umu:diva-87731DOI: 10.1111/codi.12572ISI: 000335940500009PubMedID: 24460574OAI: oai:DiVA.org:umu-87731DiVA: diva2:710620
Available from: 2014-04-07 Created: 2014-04-07 Last updated: 2017-05-29Bibliographically approved

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Rutegård, MartinHaapamäki, MarkkuRutegård, Jörgen

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