Abstract
Objectives : We evaluated the postoperative risk factors with regard to complications using the Surgical Apgar Score (SAS) and rated the usefulness of the SAS in elderly patients over 75 years of age. Methods : We analyzed the postoperative morbidity and mortality in 99 elderly patients (age : 75-99 years) who underwent surgery for colorectal cancer between 1995 and 2010 in our hospital. Results : Of the 99 patients, 88 patients (88.9%) underwent curative resection and 11 patients (11.1%) underwent non-curative resection. Preoperative disorders were noted in 32 patients (32.3%), of which cardiovascular morbidity was the most common. The rate of Grade III or IV postoperative complications was 18.3% (18 patients), and the postoperative mortality rate was 4.0% (four patients). In accordance with the SASs, 19, 76, and four patients were identified to be at low risk of postoperative complications (low risk group), at average risk (average risk group), and at high risk (high risk group), respectively. The rates of patients who developed Grade III or IV postoperative complications were 5.3%, 14.5%, and 50% in the low risk, average risk, and high risk groups, respectively ; and those of mortality were 0%, 3.9%, and 25%, respectively. The results of a ROC analysis indicated that the SAS was correlated with the complications (AUC 0.732, p=0.002). A multivariate analysis identified that the SAS (hazard ratio HR2.091, p=0.005) was a significant independent prognostic factor. Conclusion : The SAS appears to be useful for predicting the postoperative risk in elderly patients with colorectal cancer.
