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01-05-2020 | Rectal Cancer | Original Article

Predictors of readmission and reoperation in patients with colorectal cancer

Authors: José M. Quintana, Ane Anton-Ladislao, Santiago Lázaro, Nerea Gonzalez, Marisa Bare, Nerea Fernandez de Larrea, Maximino Redondo, Eduardo Briones, Antonio Escobar, Cristina Sarasqueta, Susana Garcia-Gutierrez, The REDISSEC CARESS-CCR (Results and Health Services Research in Colorectal Cancer)- group

Published in: Supportive Care in Cancer | Issue 5/2020

Abstract

Purpose

To assess the impact of readmission and reoperation on colon or rectal cancer patients in clinical and patient-reported outcome measures (PROMs) and to identify predictors of these events up to 1 year after surgery.

Methods

Prospective cohort study of patients diagnosed with colon or rectal cancer who underwent surgery at 1 of 22 hospitals. Medical history, clinical parameters, and PROMs were evaluated as possible predictors. Multivariable multilevel logistic regression and survival models were used in the analyses to create the clinical prediction rules. Models were developed in a derivation sample and validated in a different sample.

Results

Readmission and reoperation were related to clinical outcomes and changes in some PROMs. Predictors of readmission in colon cancer were ASA class (odds ratio (OR) 4.5), TNM (OR for TNM III 3.24, TNM IV 4.55), evidence of residual tumor (R2) (OR 3.96), and medical (OR 1.96) and infectious (OR 2.01) complications within 30 days after surgery, while for rectal cancer, the predictors identified were age (OR 1.03), R2 (OR 6.48), infectious complications within 30 days (OR 2.29), hemoglobin (OR 3.26), lymph node ratio (OR 2.35), and surgical complications within 1 month (OR 3.04). Predictors of reoperation were TNM IV (OR 5.06), surgical complications within 30 days (OR 1.98), and type and site of tumor (OR 1.72) in colon cancer and being male (OR 1.52), age (OR 1.80), stoma (OR 1.87), and surgical complications within 1 month (OR 1.95) in rectal cancer.

Conclusions

Our clinical prediction rule models are easy to use and could help to develop and implement interventions to reduce preventable readmissions and reoperations.

Trial registration

https://clinicaltrials.gov/ct2/show/NCT02488161 Identifier: NCT02488161

Available only for authorised users

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Title: Predictors of readmission and reoperation in patients with colorectal cancer
Authors: José M. Quintana
Ane Anton-Ladislao
Santiago Lázaro
Nerea Gonzalez
Marisa Bare
Nerea Fernandez de Larrea
Maximino Redondo
Eduardo Briones
Antonio Escobar
Cristina Sarasqueta
Susana Garcia-Gutierrez
The REDISSEC CARESS-CCR (Results and Health Services Research in Colorectal Cancer)- group
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Rectal Cancer
Rectal Cancer
Colorectal Cancer
Colorectal Cancer
Colon Cancer
Colon Cancer
Published in: Supportive Care in Cancer / Issue 5/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-019-05050-2

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