COPD is a clear risk factor for increased use of resources and adverse outcomes in patients undergoing intervention for colorectal cancer: a nationwide study in Spain

Figures & data

Table 1 Sociodemographic and clinical variables in patients with COPD versus in those without, 2010–2012

Variable	COPD				P-value
	No (N=2,276)		Yes (N=472)
	n	%	n	%
Sex					<0.001
Male	1,368	60.1	380	80.5
Female	908	39.9	92	19.5
Age (years)					<0.001
<80	1,937	85.3	350	74.2
≥80	335	14.7	122	25.8
Chronic alcoholism					<0.001
No	1,915	89.0	352	77.9
Yes	237	11.0	100	22.1
Smoking habit					<0.001
No	1,980	87.8	376	81.4
Yes	275	12.2	86	18.6
BMI (kg/m^2)					0.846
Low	12	0.7	3	0.8
Normal	522	30.1	108	28.6
Overweight/obesity	1,202	69.2	266	70.6
Comorbidities
Charlson Index					<0.001
0	1,913	84.1	322	68.7
1–2	299	13.1	124	26.4
≥3	64	2.8	23	4.9
Ischemic heart disease					0.004
No	2,166	95.3	431	92.1
Yes	106	4.7	37	7.9
Heart failure (moderate/severe)					<0.001
No	2,104	92.4	376	79.7
Yes	172	7.6	96	20.3
Peripheral vascular disease					<0.001
No	2,186	96.0	418	89.1
Yes	90	4.0	51	10.9
Cerebrovascular disease					0.299
No	2,175	95.6	443	94.5
Yes	101	4.4	26	5.5
Dementia					0.301
No	2,258	99.2	463	98.7
Yes	18	0.8	6	1.3
Peptic ulcer					<0.001
No	2,165	95.2	415	88.5
Yes	110	4.8	54	11.5
Connective tissue disease					1.000
No	2,267	99.6	467	99.6
Yes	9	0.4	2	0.4
Liver disease					<0.001
No	2,226	97.8	443	94.5
Yes	50	2.2	26	5.5
Diabetes					<0.001
No	1,866	82.0	348	74.2
Yes	410	18.0	121	25.8
Renal failure (moderate/severe)					0.079
No	2,225	97.8	452	96.4
Yes	51	2.2	17	3.6
Hemiplegia					0.305
No	2,265	99.5	465	99.1
Yes	11	0.5	4	0.9
Leukemia, lymphoma, or any other tumor (past 5 years)					0.001
No	2,124	93.3	416	88.7
Yes	152	6.7	53	11.3
Metastatic solid tumor (different from colorectal cancer)					0.238
No	2,256	99.1	468	99.8
Yes	20	0.9	1	0.2
AIDS					–
No	2,276	100.0	469	100.0
Yes	0	0.0	0	0.0
ASA score					<0.001
I–II	1,402	63.4	145	31.5
III	751	34.0	269	58.5
IV	59	2.7	46	10.0
Tumor and intervention
Location					0.554
Colon	1,633	71.7	345	73.1
Rectum	643	28.3	127	26.9
Stage					0.193
I	501	22.1	125	26.7
II	798	35.2	156	33.3
III	749	33.1	143	30.6
IV	216	9.5	44	9.4
Urgency of intervention					0.302
No	2,197	96.5	451	95.6
Yes	79	3.5	21	4.4
Type of surgery					0.001
Laparoscopic	1,342	59.6	237	50.9
Open	910	40.4	229	49.1

Abbreviations: BMI, body mass index; ASA, American Society of Anesthesiologists.

Table 2 Process and outcome variables in patients with COPD versus in those without, 2010–2012

Variable	COPD				P-value	OR (95% CI)
	No (N=2,276)		Yes (N=472)
	n	%	n	%
Complications
Severity of complications					<0.001
No	1,193	52.4	177	37.5
Minor	481	21.1	114	24.2		1.597 (1.234–2.068)
Major	602	26.4	181	38.3		2.027 (1.611–2.549)
Infectious (major)					<0.001
No	2,021	88.8	388	82.2
Yes	255	11.2	84	17.8		1.716 (1.311–2.246)
Hemorrhagic (major)					0.286
No	2,159	94.9	442	93.6
Yes	117	5.1	30	6.4		1.252 (0.828–1.895)
Surgical (major)					<0.001
No	2,004	88.0	380	80.5
Yes	272	12.0	92	19.5		1.784 (1.375–2.315)
Vascular (major)					0.035
No	2,166	95.2	438	92.8
Yes	110	4.8	34	7.2		1.529 (1.027–2.276)
Medical (major)					<0.001
No	2,141	94.1	409	86.7
Yes	135	5.9	63	13.3		2.443 (1.779–3.355)
Use of resources
Intensive care unit admission					<0.001
No	1,743	76.6	325	68.9
Yes	533	23.4	147	31.1		1.479 (1.190–1.839)
Invasive mechanical ventilation					0.027
No	2,221	97.6	452	95.8
Yes	55	2.4	20	4.2		1.787 (1.061–3.011)
In-hospital antibiotic treatment (postintervention)					0.001
No	1,274	56.0	223	47.2
Yes	1,002	44.0	249	52.8		1.420 (1.164–1.732)
Blood transfusion					0.444
No	1,702	74.8	345	73.1
Yes	574	25.2	127	26.9		1.092 (0.872–1.366)
Reintervention					0.010
No	2,106	92.5	420	89.0
Yes	170	7.5	52	11.0		1.534 (1.105–2.129)
Postintervention LOS (days)					<0.001
1–7	1,104	48.5	164	34.7
8–15	799	35.1	194	41.1		1.634 (1.303–2.051)
16–30	278	12.2	78	16.5		1.889 (1.399–2.549)
>30	93	4.1	36	7.6		2.606 (1.715–3.959)
In-hospital death					<0.001
No	2,256	99.1	451	95.6
Yes	20	0.9	21	4.4		5.252 (2.824–9.770)

Abbreviations: LOS, length of stay; OR, odds ratio; 95% CI, 95% confidence interval.

Table 3 Major complications in patients with COPD versus in those without COPD

Type of complication	COPD				P-value
	No (N=2,276)		Yes (N=472)
	N	%Col	N	%Col
Infectious					<0.001
No	2,021	88.8	388	82.2
Yes	255	11.2	84	17.8
Pneumonia					0.018
No	2,250	98.9	460	97.5
Yes	26	1.1	12	2.5
Catheter infection					0.006
No	2,235	98.2	454	96.2
Yes	41	1.8	18	3.8
Sepsis					0.158
No	2,266	99.6	467	98.9
Yes	10	0.4	5	1.1
Septic shock					0.030
No	2,224	97.7	453	96.0
Yes	52	2.3	19	4.0
Localized intra-abdominal infection (abscess)					0.341
No	2,204	96.8	453	96.0
Yes	72	3.2	19	4.0
Peritonitis					0.036
No	2,212	97.2	450	95.3
Yes	64	2.8	22	4.7
Deep surgical infection					0.705
No	2,211	97.1	457	96.8
Yes	65	2.9	15	3.2
Respiratory tract infection					0.001
No	2,266	99.6	462	97.9
Yes	10	0.4	10	2.1
Hemorrhagic complication					0.286
No	2,159	94.9	442	93.6
Yes	117	5.1	30	6.4
Bleeding wound					0.905
No	2,225	97.8	461	97.7
Yes	51	2.2	11	2.3
Internal bleeding of other organs					0.074
No	2,222	97.6	454	96.2
Yes	54	2.4	18	3.8
Hemoperitoneum					0.309
No	2,255	99.1	465	98.5
Yes	21	0.9	7	1.5
Surgical complication					<0.001
No	2,004	88.0	380	80.5
Yes	272	12.0	92	19.5
Wound leakage					0.007
No	2,214	97.3	448	94.9
Yes	62	2.7	24	5.1
Anastomotic leakage					0.022
No	2,193	96.4	444	94.1
Yes	83	3.6	28	5.9
Evisceration					0.003
No	2,250	98.9	458	97.0
Yes	26	1.1	14	3.0
Necrosis (abdominal wall)					0.390
No	2,269	99.7	469	99.4
Yes	7	0.3	3	0.6
Enterocutaneous fistula					0.110
No	2,249	98.8	462	97.9
Yes	27	1.2	10	2.1
Biliary fluid in peritoneum					0.530
No	2,273	99.9	471	99.8
Yes	3	0.1	1	0.2
Urological injuries					1.000
No	2,266	99.6	470	99.6
Yes	10	0.4	2	0.4
Vascular injuries					0.010
No	2,272	99.8	467	98.9
Yes	4	0.2	5	1.1
Neurological injuries
No	2,276	100.0	472	100.0
Yes	0	0.0	0	0.0
Other organ laceration					0.099
No	2,246	98.7	461	97.7
Yes	30	1.3	11	2.3
Vascular					0.035
No	2,166	95.2	438	92.8
Yes	110	4.8	34	7.2
Transient ischemic attack					0.530
No	2,273	99.9	471	99.8
Yes	3	0.1	1	0.2
Pulmonary embolism					0.038
No	2,274	99.9	469	99.4
Yes	2	0.1	3	0.6
Angor or acute myocardial infarction					0.075
No	2,171	95.4	441	93.4
Yes	105	4.6	31	6.6
Medical complication					<0.001
No	2,141	94.1	409	86.7
Yes	135	5.9	63	13.3
Cardiac arrest					<0.001
No	2,273	99.9	465	98.5
Yes	3	0.1	7	1.5
Heart failure					0.016
No	2,244	98.6	458	97.0
Yes	32	1.4	14	3.0
Kidney failure					<0.001
No	2,224	97.7	447	94.7
Yes	52	2.3	25	5.3
Respiratory problems/failure					<0.001
No	2,215	97.3	438	92.8
Yes	61	2.7	34	7.2
Intestinal obstruction					0.166
No	2,254	99.0	464	98.3
Yes	22	1.0	8	1.7
Multiorgan failure					0.076
No	2,267	99.6	467	98.9
Yes	9	0.4	5	1.1

Abbreviation: %Col, column percentage.

Figure 1 In-hospital survival function in patients with and without COPD.