Analysis of short-term functional outcomes of colorectal resections in older adults aged 75 years and older: a prospective single health board cohort study.

Abstract

Introduction: The global increase in life expectancy is likely to lead to a higher number of older patients undergoing colorectal resections. This is an understudied cohort, with available data concentrating on generic surgical outcomes such as postoperative complications and mortality rates. Few studies have explored quality of life and return to baseline in this cohort.

Methods: Inpatient outcome data on all patients aged 75 years and over who underwent colorectal resection in our region between 2018 and 2023 were collected prospectively. Patient characteristics, complication rates, functional decline and mortality data were documented. These data were supplemented with a subsequent review of death, readmission, and admission to a non-own home environment post-surgery.

Results: Of 408 colorectal surgery patients, 303 were elective and 105 were emergency cases. Of these cases, 59.4% (n = 180) of elective cases and 71.4% (n = 75) of emergency patients experienced a postoperative complication. In total, 35.5% of patients experienced a functional decline with reduced mobility or ability to perform independent care. Emergency patients (n = 21, 20%) demonstrated a higher mortality rate at 1 year than elective cases (n = 25, 8.3%).

Conclusion: Colorectal surgery in patients aged 75 years and older presents significant risks, particularly in emergencies. This study documents high rates of functional decline, complications and mortality in elderly patients. It highlights the need for individualised surgical care planning and enhanced perioperative counselling, and helps quantify this functional deterioration.