Table 2

Patient-based factors for EP with colorectal cancer

AuthorsStudy designPatient groupComparator(s)AssociatedNot associatedEvidence
[Askari et al] (UK, England; 2013)10Observational (retrospective analysis of hospital colorectal cancer database)237 emergency surgeries1025 elective surgeriesCancer site—colon (OR=2.76–4.83)Age; gender; deprivation; ethnicity; comorbidityM
Cleary et al (UK, England; 2007)27Case–control62 EP patients (median age 75); 44% male287 elective patients (median age 73); 52% male 310 age-sex matched controlsSymptoms—abdominal pain (OR=6.2), weight loss (OR=3.4), diarrhoea (OR=2.6)Symptoms—rectal bleedingS–
[Gould et al] (Australia; 2013)29Observational (retrospective analysis of admission episodes)30 EP patients (mean age 75)Symptoms—bowel obstruction (±perforation)I
Gunnarsson et al (Sweden; 2011)21Case–control (nested)97 EP patients (median age 77); 49% male488 elective patients (median age 74); 50% maleAge—older (median 77 vs 74 years, p=0.02); cancer site—ascending/sigmoid colon (p=0.04)Gender; comorbidity (hypertension); marital status; home ownership; residence (urban/rural)M
Gunnarsson et al (Sweden; 2013)12Observational (retrospective analysis of cancer registry, labour and tax data)2856 EP patients (35% aged >80); 47% male9437 elective patients (28% aged >80); 49% maleAge—older (≥80 years p<0.001*); marital status—unmarried (OR=1.24); income—lower (OR=1.22); education—lower (p=0.018*); childlessness (p=0.021*)GenderS
[Khamizar et al] (Malaysia; 2010)30Observational (retrospective analysis of cancer registry data)42 emergency surgeries123 elective surgeriesSymptoms—abdominal pain, change in bowel habit; cancer site—colonI
Khattak et al (UK, England; 2006)22Cross-sectional58 emergency admissions (median age 72); 57% male (of all patients)43 elective admissions (median age 72); 57% male (of all patients)Symptoms—shorter time to presentation (median 11.5 vs 49.5 days, p=0.04)M
MacDonald et al (UK, Scotland; 2011)13Observational (retrospective analysis of cancer audit data)395 EP patients (mean age 71); 56% male (of all patients)1223 elective patients (mean age 68); 56% male (of all patients)Age—older (mean 70.6 vs 67.9 years p<0.005)S
Mitchell et al (Canada; 2007)24Cross-sectional108 emergency resections (mean age 71); 40% male347 elective resections (mean age 67); 56% maleAge—older (mean 70.8 vs 67.0 years, p=0.005); Gender—female (29.7% vs 18.2%, p=0.004); symptoms—obstruction (43% vs 2%), pain (23% vs 8%); BMI—extreme (<25 or >40, p=0.001)Annual household income; Education level; smoking history; family history; previous CRC screeningS−
Oldale et al (UK, England; 2000)25Cross-sectional100 emergency admissions (50% aged ≥75); 47% male357 elective admissions (37% aged ≥75); 59% maleAge—older (≥75 years, 42% vs 34%, p=0.05); marital status—single, divorced, widowed (44% vs 35%, p=0.07)Gender; deprivationS
Oliphant et al (UK, Scotland; 2013)14Observational (retrospective analysis of cancer registry, SMR1 and deaths data)945 EP patients3351 elective patientsDeprivation—higher (23.5% vs 19.5%, p=0.033)S
Polednak (USA; 2000)15Observational (retrospective analysis of cancer registry and hospital discharge data)2183 emergency admissions (56% aged ≥75); 46% male8840 all other route patients (39% aged ≥75); 51% maleAge—older (75 to ≥85 years, OR=1.89–3.42); Gender—female (53.8% vs 48.7%, p<0.001*); ethnicity—black (OR=1.76); insurance—self-pay (OR=2.08), Medicaid (OR=2.66)S
Pollock and Vickers (UK, England; 1998)16Observational (retrospective analysis of HES and census data)53 742 patientsDeprivation—higher (Q3-Q10 OR=1.27–2.29)S
Porta et al (Spain; 1998)26Cross-sectional161 emergency admissions (median age 67); 63% male87 elective admissions (median age 70); 64% maleSymptoms—anorexia, weakness, weight loss (24.8% vs 9.2%, p<0.01); symptoms—no presentation at first symptom (34.2% vs 13.8%, p<0.01)Age; gender; social class; family history; cancer siteS–
Rabeneck et al (Canada; 2006)17Observational (retrospective analysis of Institute for Health information and health insurance data)7739 OPE patients (64% aged >70); 50% male33 617 non-OPE patients (53% aged >70); 54% maleAge—older (10-year increment OR=1.19); gender—female (male, OR=0.93); income—lower (highest income, OR=0.78); comorbidity (score 1 to ≥3, OR=1.80–3.51); primary care use—lower (regular care, OR=0.70); previous investigation—lower (Ix in 5 years, OR=0.69)S
Raine et al (UK, England; 2010)18Observational (retrospective analysis of HES data)60 684 EP admissions (aged 50–90+); 51% male126 293 non-EP admissions (aged 50–90+); 57% maleAge—older (70 to ≥90years, OR=1.41–5.85); gender—female (OR=1.15); deprivation—higher (OR=0.66, least deprived)S
Sikka and Ornato (USA; 2012)19Observational (retrospective analysis of cancer registry, health insurance and census data)2092 EP patients (43% aged >80); 42% male6938 non-emergency patients (33% aged >80); 47% maleAge—older (75 to ≥85 years, OR=1.45–1.89); gender—female (OR=1.18); health insurance (OR=1.37); comorbidity (score 1 to 3+, OR=1.89–4.11); primary care use—lower (≥1 visit, OR=0.68); secondary care use—higher (≥1 admit, OR=1.29); ED use—higher (p<0.05)Annual household income; ethnicityS
[Sivakumaran et al] (Australia; 2013)31Observational (retrospective medical records review)97 EP patients (median age 76); 56% male (of all patients)223 elective patients (median age 69); 56% male (of all patients)Age—older (median 76 vs 69 years, p<0.001); cancer site—colon (rectal cancer, OR=3.20)I
  • [Abstract only].

  • *Associated in univariate analysis.

  • BMI, body mass index; CRC, colorectal cancer; EP, emergency presentation; HES, Hospital Episodes Statistics; I, insufficient; Ix, investigation; M, moderate; S–, strong–; S, strong; SMR, Scottish Morbidity Recording.