Retrospective Study
Copyright ©The Author(s) 2016.
World J Gastroenterol. Nov 21, 2016; 22(43): 9544-9553
Published online Nov 21, 2016. doi: 10.3748/wjg.v22.i43.9544
Table 1 Patient characteristics, tumor factors and postoperative outcomes by type of procedure for patients undergoing colorectal resection, ACS-NSQIP 2005-2012
Characteristics, mean (± SD), (n)Open colectomy n (%)Lap colectomy n (%)P value
Age 61.3 ± 15.1761.89 ± 15.3160.55 ± 14.93< 0.0001
Race
AA (8778)5823 (10.46)2955 (7.55)< 0.0001
White (73879)42801 (76.90)31087 (79.38)
Other (3808)2043 (3.67)1765 (4.51)
Unknown (8346)4992 (8.97)3354 (8.57)
Gender0.62
Male (45383)26606 (47.08)18777 (47.96)
Female (49428)29053 (52.50)20375 (52.04)
ASA
Unknown (84)60 (0.11)24 (0.06)< 0.0001
1 (2962)1276 (2.30)1686 (4.31)
2 (46287)23687 (42.50)22600 (57.72)
3 (40773)26898 (48.30)13875 (35.44)
4 (4627)3664 (6.58)963 (2.46)
5 (78)74 (0.13)4 (0.01)
Frailty index
0 (42507)23651 (42.49)18856 (48.16)< 0.0001
1 (35596)20838 (37.44)14759 (37.69)
2 (11774)7562 (13.59)4212 (10.76)
≥ 3 (4934)3608 (6.48)1326 (3.39)
Type of intervention< 0.0001
APR (524)524 (100)0 (0)
LAR (21300)12056 (21.66)9244 (23.61)
TPC (3760)2514 (4.52)1246 (3.18)
Total colectomy (3210)2556 (4.59)654 (1.67)
Partial colectomy (61646)34311 (61.65)27335 (69.82)
Sigmoid colectomy (4371)3698 (6.64)673 (1.72)
Complication
Yes (23755)17241 (30.98)6514 (16.64)< 0.0001
No (71056)38418 (69.02)32638 (83.36)
Complication by severity
Minor (9,996)6884 (12.37)3112 (7.95)< 0.0001
Mayor (13759)10357 (18.61)3402 (8.69)
No complication (71056)38418 (69.02)32638 (83.36)
LOS, 8.32 ± 9.289.88 ± 10.375.89 ± 6.40< 0.0001
Prolonged LOS
Yes (4472)3768 (10.42)704 (3.19)< 0.0001
No (53755)32397 (89.58)21358 (96.81)
Mortality (30 d)
Yes (1766)1463 (2.63)303 (0.77)< 0.0001
No (93045)54196 (97.37)38849 (99.23)
Total patients55659 (58.7)39152 (41.3)94811
Table 2 Univariate and multivariate mortality analysis by frailty group patients undergoing colon resection, ACS-NSQIP 2005-2012
CharacteristicMortality n (%)P valueOR (95%CI), P value
Non frail (n = 42507)
AgeYes: 65.22 ± 15.23< 0.00010.94 (0.95-1.05), < 0.0001
No: 53.84 ± 15.09
Race
AA20 (0.71)0.60-
White186 (0.55)
Other10 (0.54)
Unknown20 (0.47)
Gender
Male122 (0.60)0.201.34 (1.03-1.75), 0.028
Female114 (0.51)Ref
Type of intervention< 0.0001
APR1 (0.40)0.45 (0.02-2.04), 0.36
LAR31 (0.31)0.53 (0.35-0.77), 0.0008
TPC8 (0.32)0.81 (0.36-1.57), 0.56
Total colectomy15 (0.89)1.82 (1.02-3.04), 0.04
Partial colectomy162 (0.62)Ref
Sigmoid colectomy19 (1.16)1.18 (0.66-1.96), 0.54
Procedure
Open204 (0.86)< 0.00014.65 (3.16-6.82), < 0.0001
Lap32 (0.17)Ref
Characteristic mildly frail (n = 35596)
AgeYes: 72.84 ± 12.25< 0.00010.94 (0.95-1.05), < 0.0001
No: 65.75 ± 12.36
Race0.59
AA68 (1.64)
White453 (1.67)
Other20 (1.38)
Unknown57 (1.92)
Gender0.006
Male302 (1.89)1.58 (1.33-1.88), < 0.0001
Female296 (1.51)Ref
Type of intervention< 0.0001
APR5 (2.55)1.14 (0.34-2.73), 0.79
LAR85 (1.05)0.68 (0.53-1.87), 0.0018
TPC14 (1.54)1.07 (0.58-1.81), 0.79
Total colectomy31 (3.27)1.94 (1.28-2.84), 0.00025
Partial colectomy405 (1.70)Ref
Sigmoid colectomy58 (3.48)1.77 (1.30-2.36), 0.0003
Procedure
Open470 (2.26)< 0.00012.35 (1.92-2.91), < 0.0001
Lap128 (0.87)Ref
Characteristic moderately frail (n = 11744)
AgeYes: 74.7 ± 10.95< 0.00010.96 (0.11-17.47), < 0.0001
No: 70.28 ± 11.2
Race
AA49 (3.86)0.65-
White368 (3.96)
Other13 (3.53)
Unknown40 (4.76)
Gender0.34
Male265 (4.15)-
Female205 (3.81)
Type of intervention< 0.0001
APR29 (3.77)0.89 (0.14-2.92), 0.87
LAR54 (2.39)0.68 (0.49-0.91), 0.018
TPC13 (5.94)1.70 (0.88-2.98), 0.10
Total colectomy28 (7.78)2.29 (1.48-3.40), 0.0003
Partial colectomy317 (3.86)Ref
Sigmoid colectomy56 (8.41)2.08 (1.50-2.83), < 0.001
Procedure
Open395 (5.22)< 0.00012.70 (2.08-3.54), < 0.0001
Lap75 (1.78)Ref
Characteristic: Severely frail (n = 4934)
AgeYes: 75.92 ± 9.51< 0.00010.96 (0.15-13.07), < 0.0001
No: 71.94 ± 10.02
Race
AA50 (8.80)0.42-
White381 (9.61)
Other7 (5.79)
Unknown24 (8.54)
Gender
Male281 (10.16)0.031.42 (1.16-1.75), 0.0006
Female181 (8.35)Ref
Type of intervention< 0.0001
APR2 (8.33)0.75 (0.12-2.62), 0.69
LAR46 (5.67)0.63 (0.45-0.88), 0.0058
TPC10 (10.10)1.15 (0.55-2.15), 0.68
Total colectomy35 (16.67)2.07 (1.38-3.03), 0.0006
Partial colectomy299 (8.82)Ref
Sigmoid colectomy70 (17.59)1.94 (1.41-2.62), < 0.0004
Procedure
Open394 (10.92)< 0.00012.13 (1.62-2.84), < 0.0001
Lap68 (5.13)Ref
Table 3 Univariate and multivariate complication analysis by frailty group patients undergoing colorectal resection, ACS-NSQIP 2005-2012
CharacteristicComplication n (%)P valueOR (95%CI), P value
Non frail (n = 42507)
AgeYes: 53.74 ± 15.81< 0.00010.94 (0.95-1.05), < 0.001
No: 53.94 ± 14.93
Race
AA719 (25.63)< 0.00011.29 (1.18-1.41), < 0.0001
White6736 (20.07)Ref
Other362 (19.37)0.98 (0.87-1.10), 0.77
Unknown906 (21.24)1.06 (0.98-1.15), 0.11
Gender
Male4191 (20.73)0.30
Female4532 (20.33)
Type of intervention< 0.0001
APR55 (21.91)0.87 (0.64-1.18), 0.37
LAR1858 (18.32)0.97 (0.91-1.03), 0.34
TPC733 (28.95)1.71 (1.55-1.87), < 0.0001
Total colectomy536 (31.66)1.77 (1.59-1.98), < 0.0001
Partial colectomy18.58 (18.32)Ref
Sigmoid colectomy573 (34.90)1.88 (1.69-2.10), < 0.0001
Procedure
Open6143 (25.97)< 0.00012.07 (1.97-2.18), < 0.0001
Lap2580 (13.68)Ref
Characteristic, mildly frail (n = 35596)
AgeYes: 65.81 ± 13.06< 0.00010.94 (0.94-0.95), < 0.0001
No: 65.00 ± 12.17
Race
AA1154 (27.90)< 0.00011.15 (1.07-1.24), 0.0002
White6637 (24.54)Ref
Other291 (20.07)0.81 (0.70-0.93), 0.0026
Unknown734 (25.78)1.06 (0.97-1.16), 0.18
Gender0.34
Male4017 (25.09)-
Female4829 (24.66)
Type of intervention< 0.0001
APR61 (31.12)1.09 (0.80-1.48), 0.55
LAR1918 (23.72)1.01 (0.95-1.08), 0.58
TPC341 (37.47)1.78 (1.54-2.05), < 0.0001
Total colectomy370 (39.07)1.75 (1.53-2.01), < 0.0001
Partial colectomy5500 (23.12)Ref
Sigmoid colectomy656 (39.40)1.78 (1.60-1.98), < 0.0001
Procedure
Open6360 (30.52)< 0.00012.05 (1.94-2.16), < 0.00001
Lap2486 (16.85)Ref
Characteristic moderately frail (n = 11774)
AgeYes: 70.480 ± 11.81< 0.00010.99 (0.99-1.00), < 0.0001
No: 70.42 ± 10.82
Race
AA472 (37.19)0.00131.20 (1.06-1.37), 0.003
White2996 (32.21)Ref
Other118 (32.07)1.01 (0.80-1.26), 0.93
Unknown299 (35.81)1.12 (0.96-1.31), 0.13
Gender
Male2029 (31.75)0.00170.92 (00.85-1.00), 0.06
Female1856 (34.48)Ref
Type of intervention< 0.0001
APR19 (35.85)0.97 (0.52-1.70), 0.92
LAR726 (32.12)1.05 (0.95-1.17), 0.28
TPC110 (50.23)2.10 (1.49-2.63), < 0.0001
Total colectomy182 (50.56)2.05 (1.65-2.55), < 0.0001
Partial colectomy2522 (30.70)Ref
Sigmoid colectomy326 (48.95)1.96 (1.66-2.31), < 0.0001
Procedure
Open2896 (38.38)< 0.00011.89 (1.73-2.07), < 0.0001
Lap989 (23.48)Ref
Characteristic severely frail (n = 4934)
AgeYes: 71.89 ± 10.500.020.96 (0.040-0.17), < 0.0001
No: 72.54 ± 9.57
Race
AA295 (51.94)0.0421.18 (0.98-1.42), 0.06
White1822 (45.96)Ref
Other51 (42.15)0.90 (0.682-1.33), 0.61
Unknown133 (45.96)1.02 (0.79-1.32), 0.84
Gender
Male1308 (42.27)0.31-
Female993 (45.82)
Type of intervention< 0.0001
APR12 (50)1.05 (0.46-2.38), 0.89
LAR350 (43.10)0.98 (0.84-1.15), 0.85
TPC53 (53.54)1.27 (0.85-1.91), 0.23
Total colectomy134 (63.81)1.96 (1.46-2.64), < 0.0001
Partial colectomy1499 (44.21)Ref
Sigmoid colectomy253 (63.57)1.94 (1.56-2.44), < 0.0001
Procedure
Open1842 (51.05)< 0.00011.83 (1.60-2.09), < 0.0001
Lap459 (3462)Ref