What are the risk factors for readmission in patients with an ileostomy?

Author:

Campos-Lobato Luiz Felipe de12,Alves-Ferreira Patricia Cristina23,Oliveira Paulo Gonçalves de13,Sousa João Batista de13,Vogel Jon D.4

Affiliation:

1. Division of Coloproctology, Escola de Medicina, Universidade de Brasília, Brasília, DF, Brazil

2. Instituto Brasileiro de Coloproctologia, Brasília, DF, Brazil

3. Program in Medical Sciences, Escola de Medicina, Universidade de Brasília, Brasília, DF, Brazil

4. Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, US

Abstract

Abstract Purpose the aim of this study was to identify the risk factors for readmission among patients submitted to colorectal surgery. Methods a single-center colorectal quality-assessment database was queried for patients undergoing colorectal procedures with ileostomy during 2009. the sample was divided into readmitted vs. non-readmitted. readmission was defined as admission within the first 30 days after the index procedure. Groups were compared by pre, intra and postoperative characteristics. A multivariate analysis was performed to identify the risk factors for readmission. Results the query returned 496 patients, [267 (54%) males, median age 48 years (iQr: 34-60)]. Eighty-three (17%) were readmitted; 296 patients (60%), were operated due to inflammatory bowel disease, 89 (18%) for cancer, 16 (3%) for diverticular disease and 95 (19%) for other diagnosis. the three most common procedures were total proctocolectomy with ileal pouch-anal anastomosis (iPAA) in 103 patients (21%), total colectomy with end ileostomy in 117 (24%) and small bowel resections (including enterocutaneous fistula takedown and J-pouch excision) in 149 (30%). the following variables were significantly more common in readmitted patients: current smoking (24% vs. 14%, p = 0.02), postoperative DVt/PE (10% vs. 4%, p = 0.04), wound infection (20% vs. 10% p = 0.01), sepsis (22% vs. 8% p < 0.001) and organ or space surgical site infection (orgSSi) (35% vs. 5%, p < 0.001). Postoperative orgSSi was the only independent factor associated with readmission in a multivariate analysis (p < 0.001). Conclusion colorectal surgeons should be alert for orgSSi when facing an ileostomy patient readmitted after a colorectal procedure.

Publisher

Georg Thieme Verlag KG

Subject

Gastroenterology

Reference16 articles.

1. increase of serum C-reactive protein is an early indicator of subsequent symptomatic anastomotic leakage after anterior resection;Matthiessen;Colorectal Dis.,2008

2. Hyman nH, buie WD, Standards Practice task Force of the American Society of Colon and rectal Surgeons;Strong;Practice parameters for the surgical management of Crohn's disease. Dis Colon Rectum.,2007

3. Management of rectal cancer;Wu;J Gastrointest Surg.,2004

4. Brown Sr, Wadhawan H, nelson rL. Surgery for faecal incontinence in adults. Cochrane Database Syst Rev. 2010;(9) (9):CD001757.

5. Perforative carcinoma of colon and rectum;Welch;Ann Surg.,1974

Cited by 4 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3