Patient-related factors influence the risk of developing intestinal stoma complications in early post-operative period.

Abstract:

BACKGROUND:Few studies have investigated the risk factors associated with developing intestinal stoma complications using appropriate multivariable methods. We aimed to determine the prevalence of, and risk factors for, stomal complications. METHODS:A retrospective, case-control methodology was used to investigate 12 explanatory variables and four outcome variables in 202 consecutive patients receiving stomas in a district general hospital in the United Kingdom between January 2013 and December 2014. Univariable and multivariable logistic regression were used to calculate odds ratios (ORs). RESULTS:There were 69 complications (69/202; 34.2%) in the early post-operative period (median 12 months) in total, the most common being retraction (30.4%). Performance status (World Health Organization score 1 or more; OR 2.67; 95% confidence intervals (CIs) 1.33-5.33; P = 0.006) and body mass index (>30 kg/m2 ; OR 3.30; 95% CIs 1.61-6.78; P = 0.001) were significantly associated with developing complications in multivariable analysis. Surgery-related risk factors, such as time of day or week of operation and grade of surgeon, were not associated with the development of stoma complications. Thirty-eight patients (18.8%) died over the follow-up period, but mortality was not related to the development of stoma complications (1.01; 0.48-2.13, P = 0.98). CONCLUSION:Patient-related risk factors influence the risk of developing a stoma complication more than surgery-related risk factors. Preoperative and post-operative interventions, planning, vigilance and management should be focussed to at-risk groups, particularly obese patients.

journal_name

ANZ J Surg

journal_title

ANZ journal of surgery

authors

Harilingam M,Sebastian J,Twum-Barima C,Boshnaq M,Mangam S,Khushal A,Marzouk D,Tsavellas G

doi

10.1111/ans.13397

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

E116-E120

issue

10

eissn

1445-1433

issn

1445-2197

journal_volume

87

pub_type

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