<p><b>OBJECTIVE</b>To explore the
risk factors and prevention
strategies of post-operative
complications in
elderly patients with
colorectal cancer.</p><p><b>
METHODS</b>Data of 107
elderly patients (≥75 years) undergoing
surgery for
colorectal cancer were collected from January 2006 to December 2009 in the Department of Gastrointestinal
Surgery,
Peking University People's
Hospital. POSSUM and E-POSSUM scoring systems were used to predict post-operative
complications.
ROC curve and observe/expect(O/E) were used to assess the validity of scoring systems.
Logistic regression was used to evaluate the independent
risk factors associated with post-operative
complications of
elderly patients with
colorectal cancer.</p><p><b>RESULTS</b>The predictive complication rates of E-POSSUM and POSSUM in
elderly patients with
colorectal cancer were 13.9%-86.6%(average, 32.7%) and 19.1%-99.1% (average, 55.5%). The predictive validity of E-POSSUM was better than POSSUM(
AUC of ROC 0.862 vs. 0.576, O/E 0.771 vs. 0.454), the former was closer to the actual complication rate(25.2%, 27/107). Concurrent
diabetes mellitus(P=0.019) and rectal lesion(P=0.005) were independent
risk factors associated with
surgery-related post-operative
complications.
Anastomotic leakage was the most common
surgery-related post-operative
complications.
Chronic obstructive pulmonary disease(P=0.026), ASA score(P=0.025),
intestinal obstruction(P=0.037) and perforation(P=0.001) were independent
risk factors associated with non-
surgery-related post-operative
complications. Pulmonary
infection was the most common non-
surgery-related post-operative complication.</p><p><b>CONCLUSIONS</b>The application of E-POSSUM scoring system can provide more accurate prediction of post-operative
complications in
elderly patients undergoing
surgery for
colorectal cancer. Positive interventions should be taken for high-
risk patients to prevent post-operative
complications.</p>