ORIGINAL RESEARCH article
Front. Surg.
Sec. Colorectal and Proctological Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1649766
Mortality Risk Prediction in Octogenarians Undergoing Emergency Colorectal Surgery: a Tertiary Center Experience and Systematic Review of the Literature
Provisionally accepted
Marco Brolese1,2,3*
Arianna Vittori1,2,3
Matteo Todisco3Nadine Zuin1,2,3Vanessa Cusano1,2,3Valeria Valli2,3Lorenzo Vallese2,3Nicola Baldan2,3
Michele Valmasoni1,2,3Gianfranco Da Dalt2,3Alberto Friziero2,3- 1Universita degli Studi di Padova, Padua, Italy
- 2Universita degli Studi di Padova Dipartimento di Scienze Chirurgiche Oncologiche e Gastroenterologiche, Padua, Italy
- 3Azienda Ospedale Universita Padova, Padua, Italy
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Objective: Surgical colonic emergencies frequently occur in elderly patients. In these cases a comprehensive preoperative assessment is crucial to tailor surgical invasiveness to individual risk profiles and potentially improve clinical outcomes. The aim of our study was to identify predictors of in-hospital mortality in octogenarians undergoing emergency colorectal resections, and compare the short-term outcomes between elderly and younger patients. Methods: This study included patients who underwent emergency colorectal resections at Our Department between January 2020 and December 2024. Exclusion criteria were age <18 years and palliative surgery. Patients were stratified into two cohorts: octogenarians (≥80 years, Group 1) and patients aged <80 years (Group 2). Baseline characteristics, perioperative variables, and short-term outcomes were compared and analyzed. A systematic review (PROSPERO: CRD420251050770) was conducted to identify the studies evaluating outcomes of emergency colorectal resections in octogenarians. MEDLINE (via PubMed), EMBASE, and EBSCOhost were searched from database inception to April 2025. Results: Group 1 and Group 2 included 82 and 130 patients with median ages of 84 and 67 years, respectively. The in-hospital mortality rate was 24% in octogenarians and 8% in younger patients (p<0.001). Multivariate logistic regression identified hyperlactatemia as an independent negative prognostic factor for in-hospital mortality in octogenarians (p = 0.01). Through a systematic review of the literature we identified 12 publications, and the mortality rate ranged between 7.0-37.8%. Conclusions: Early identification of prognostic factors can improve clinical outcome in emergency scenarios. Our systematic review, the first reported in the literature, provides a comprehensive perspective in this field.
Keywords: Emergencies, acute care surgery, Colectomy, Octogenarians, Risk factors, Mortality
Received: 19 Jun 2025; Accepted: 16 Jul 2025.
Copyright: © 2025 Brolese, Vittori, Todisco, Zuin, Cusano, Valli, Vallese, Baldan, Valmasoni, Da Dalt and Friziero. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Marco Brolese, Universita degli Studi di Padova, Padua, Italy
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