Does Immediate Colon Surgery Within Two Hours Predict a Negative Postoperative Outcome? A Prospective Cohort Study.

Background: The aim of this study was to evaluate whether immediate surgery within 2 hours is a prognostic factor for adverse postoperative outcomes.

Methods: This was a prospective observational study that included all consecutive patients who underwent emergency and elective colon resection at a tertiary-level hospital for malignant or benign conditions over a 13-month period. Postoperative outcomes included morbidity, mortality, reoperation, readmission and length of stay. The statistical analysis included both univariate and multivariate tests, with statistical significance set at p<0.05.

Results: Over a 13-month period, 300 colon resections were performed. Twenty-five cases (8.3%) underwent emergency operations within 2 hours of admission. Immediate surgery was associated with worse postoperative outcomes including higher mortality and reoperation rates: 40% versus 5.8% (p <0.0001, OR: 10.79, 95% CI: 4.18-27.79) and 20% versus 6.9% (p=0.02, OR: 3.36, 95% CI: 1.19-9.97), respectively. Postoperative outcomes were also worse in operations for malignant tumors (OR: 6.97, 95% CI: 2.82-17.60, p< 0.0001).

Conclusion: Immediate colon surgery within 2 hours is a negative predictor for morbidity and mortality.