Aortic calcification is associated with non-infective rather than infective postoperative complications following colorectal cancer resection: an observational cohort study

Knight, K. A., Hon Fei, C., Boland, K. F., Dolan, D. R., Golder, A. M. , McMillan, D. C. , Horgan, P. G. , Black, D. H., Park, J. H. and Roxburgh, C. S.D. (2021) Aortic calcification is associated with non-infective rather than infective postoperative complications following colorectal cancer resection: an observational cohort study. European Radiology, 31(6), pp. 4319-4329. (doi: 10.1007/s00330-020-07189-7) (PMID:33201280)

Abstract

Objectives: Complications following colorectal cancer resection are common. The degree of aortic calcification (AC) on CT has been proposed as a predictor of complications, particularly anastomotic leak. This study assessed the relationship between AC and complications in patients undergoing colorectal cancer resection. Methods: Patients from 2008 to 2016 were retrospectively identified from a prospectively maintained database. Complications were classified using the Clavien-Dindo (CD) scale. Calcification was quantified on preoperative CT by visual assessment of the number of calcified quadrants in the proximal and distal aorta. Scores were grouped into categories: none, minor (< median AC score) and major (> median AC score). The relationship between clinicopathological characteristics and complications was assessed using logistic regression. Results: Of 657 patients, 52% had proximal AC (> median score (1)) and 75% had distal AC (> median score (4)). AC was more common in older patients and smokers. Higher burden of AC was associated with non-infective complications (proximal AC 28% vs 16%, p = 0.004, distal AC 26% vs 14% p = 0.001) but not infective complications (proximal AC 28% vs 29%, p = 0.821, distal AC 29% vs 23%, p = 0.240) or anastomotic leak (proximal AC 6% vs 4%, p = 0.334, distal AC 7% vs 3%, p = 0.077). Independent predictors of complications included open surgery (OR 1.99, 95%CI 1.43–2.79, p = 0.001), rectal resection (OR 1.51, 95%CI 1.07–2.12, p = 0.018) and smoking (OR 2.56, 95%CI 1.42–4.64, p = 0.002). Conclusions: These data suggest that high levels of AC are associated with non-infective complications after colorectal cancer surgery and not anastomotic leak.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Park, Mr James and Horgan, Professor Paul and Golder, Mr Allan and Roxburgh, Professor Campbell and Black, Dr Douglas and McMillan, Professor Donald and Knight, Miss Katrina
• Authors: Knight, K. A., Hon Fei, C., Boland, K. F., Dolan, D. R., Golder, A. M., McMillan, D. C., Horgan, P. G., Black, D. H., Park, J. H., and Roxburgh, C. S.D.
• College/School: College of Medical Veterinary and Life Sciences > School of Cancer Sciences; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: European Radiology
• Publisher: Springer
• ISSN: 0938-7994
• ISSN (Online): 1432-1084
• Published Online: 17 November 2020
• Copyright Holders: Copyright © 2020 European Society of Radiology
• First Published: First published in European Radiology 31(6): 4319-4329
• Publisher Policy: Reproduced in accordance with the publisher copyright policy