SIGNIFICANT RISK-FACTORS IN ELECTIVE COLORECTAL SURGERY

A prospective study of 618 patients undergoing elective colorectal sur gery performed in a district general hospital over a 10-year period is reported. Multivariate analysis has been used in an attempt to identi fy risk factors. The risk of wound infection was increased if septicae mia, respiratory sepsis or faecal contamination was present, if the su rgeon was a consultant and if the patient had suffered a haemorrhage. There was an increased risk of serious complications if the patient wa s male and of poor physical status. Operative mortality was significan tly associated with poor physical status, respiratory sepsis and intra -abdominal abscess. Only three risk factors could be identified preope ratively: patient gender, physical status and seniority of surgeon. Ho wever, procedures low in the pelvis are more difficult and in this stu dy group are also associated with a higher risk of wound infection. Th e majority of these procedures are performed by consultants. In additi on, this study group has proportionally more female patients of poor p hysical status who are selectively being operated on by the consultant , seemingly indicating the 'consultant' as a risk factor.