Outcomes of Veterans Affairs patients older than age 80 after surgical procedures for colon malignancies

Background: Census data predict a 43% increase in individuals who are 80 years and older by 2010. There is a lack of information concerning surgical outcomes in this patient population regarding colon cancer. Herein we report a 10-year experience of surgical outcomes. Methods: Medical records of patients age 80 years and older undergoing surgery for colon cancer from 1996 to 2006 were reviewed (study group). Patient demographics and clinical outcomes were compared with a randomly sampled control group of patients younger than 80 years. Results: Forty-seven patients 80 years and older underwent surgery. Study group patients had an increased length of stay (P = .02), more cardiopulmonary complications (P = .01), and 32% presented emergently. Emergent patients had a significantly longer hospital stay and a higher incidence of complications. Study group patients also had decreased 1-, 3-, and 5-year survival rates (71%, 48%, and 31%, respectively). Conclusions: Patients age 80 years and older have increased postoperative cardiopulmonary complications, lower long-term survival rates, and often present emergently. Clinicians should make all attempts to optimize the cardiopulmonary status preoperatively in this patient population and attempt to perform these surgeries in nonemergent situations.