Colorectal Resection and Primary Anastomosis in Patients Aged 70 and Older: Prospective Study

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Abstract
To assess the differences in morbidity, mortality, and other immediate postoperative results of colorectal resection with primary anastomosis in relation to age. Prospective study. District hospital, Spain. 316 consecutive patients who required colorectal resection with primary anastomosis between 1991 and 1995, 155 of whom were aged <70 years and 161 who were 70 years or more. Mortality, morbidity, and hospital stay 116 patients aged <70 (75%) were American Society of Anaesthesiologists (ASA) grades I-II compared with 82 (51%) aged ≥70. 33 of the younger patients (21%) and 49 of the older (30%) developed complications. The anastomotic leak rate was 14% (n = 21) in the younger group and 16% (n = 26) among those aged ≥70. Median hospital stay was 14 and 15 days, respectively (ranges 8–81 and 1–120). 4 died (3%) among those aged <70 compared with 17 (11%) in the older group (p = 0.009, chi square 6.9). Mortality for elective resections was 6% (15/263) compared with 11% (6/53) for emergencies. There were no significant differences in mortality according to ASA grade between age groups. People aged 70 or more are not a high risk group for colorectal resection and primary anastomosis as a result of their age alone. Mortality and morbidity depend more on ASA grade and whether the operation was elective or emergency.

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