P26 – Factors Associated with Postoperative Cardiac Complication in Patients with Malignant Neoplasm of Ascending Colon Underwent Elective Right Hemicolectomy

Author(s):
Yen-Hong Kuo, Yen-Liang Kuo, Nasim Ahmed, John Davis, Jersey Shore University Medical Center

Background: Postoperative cardiac complication is associated with prolonged length of hospital stay, high mortality, and the increased costs of health care. Identifying the risk factors associated with postoperative cardiac complication will improve patient care. The purpose of this study was to assess the factors which associated with the risk of developing postoperative cardiac complication in patients with malignant neoplasm of ascending colon underwent elective right hemicolectomy.

Hypothesis: Patient and hospital characteristics impact the chance of developing postoperative cardiac complication.

Methods: A retrospective cohort study was conducted by using the 2001-2006 Nationwide Inpatient Sample. Adult patients (age ≥ 18 years) with malignant neoplasm of ascending colon and scheduled for right hemicolectomy are the population of interest. Patients with a primary diagnosis of malignant neoplasm of the ascending colon (ICD-9-CM code: 153.6), with primary procedure of open and other right hemicolectomy (ORH, ICD-9-CM code: 45.73) were included for this study. Postoperative cardiac complication is the primary outcome (ICD-9-CM code: 997.1).

Results: There were estimated 66,789 patients with malignant neoplasm of the ascending colon admitted for elective ORH in 2001-2006. Among them, 2.3% experienced postoperative cardiac complication after the surgery. Patients with postoperative cardiac complication were older (mean [standard error]: 77.1 [0.5] vs. 71.4 [0.1] years, P<0.0001), but no difference in gender distribution (54.3% vs. 56.3%, P=0.49). They had a significantly higher in-hospital mortality rate (5.5% vs. 1.2%, P<0.0001). From a multiple logistic regression model, the risk of experiencing postoperative cardiac complication increased with older age (adjusted odds ratio{AOR}[95% confidence interval {CI}]: 1.04 [1.03, 1.06], P<0.0001), male gender (1.35 [1.05, 1.73], P=0.02), congestive heart failure (3.00 [2.20, 4.10], P<0.0001), coagulopathy (2.22 [1.05, 4.71], P=0.04), fluid and electrolyte disorders (1.71 [1.26, 2.32], P=0.001), and being treated in a teaching hospital (1.48 [1.13, 1.96], P=0.005).

Conclusions: This study identified factors which associated with increased risk of postoperative cardiac complication. Strategy on managing patients with those conditions can reduce the costs of health care.