Prolonged preoperative hospital stay is a risk factor for complications after emergency colectomy for severe colitis. (November 2013)

• Record Type: Journal Article
• Authors: Bartels, S. A. L.; Gardenbroek, T. J.; Bos, L.; Ponsioen, C. Y.; D'Haens, G. R. A. M.; Tanis, P. J.; Buskens, C. J.; Bemelman, W. A.
• Is Part Of: Colorectal disease. Volume 15:Number 11(2013)
• Page Start: 1392
• Page End: 1398
• Publication Date: 2013-11
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.12328
• Languages: English
• ISSNs: 1462-8910

Abstract

<abstract abstract-type="main" id="codi12328-abs-0001"> <title>Abstract</title> <sec id="codi12328-sec-0001" sec-type="section"> <title>Aim</title> <p>Risk factors for postoperative complications in patients undergoing emergency colectomy for severe colitis in inflammatory bowel disease have hardly been studied. Therefore, this study aimed to define predictors of a complicated postoperative course in these patients.</p> </sec> <sec id="codi12328-sec-0002" sec-type="section"> <title>Method</title> <p>A retrospective review was performed of 71 consecutive patients who underwent emergency colectomy for severe colitis between 1999 and 2012 at a tertiary referral centre. Complications were graded according to the Clavien–Dindo classification. Patients with a complication Grade II or higher were compared with those with no complications or a Grade I complication.</p> </sec> <sec id="codi12328-sec-0003" sec-type="section"> <title>Results</title> <p>Nineteen patients (26.7%) had at least one postoperative complication classified as Clavien–Dindo Grade II or higher. In the group with postoperative complications, patients had a higher age (mean 45 <italic>vs</italic> 35 years, <italic>P </italic>=<italic> </italic>0.020) and a higher body mass index (BMI) (mean 25.9 <italic>vs</italic> 21.0 kg/m<sup>2</sup>, <italic>P </italic>=<italic> </italic>0.006). Length of preoperative hospital stay (median 15 <italic>vs</italic> 6 days, <italic>P </italic>=<italic> </italic>0.032) was longer in the group with postoperative complications. During the study period, the preoperative hospital stay decreased by 0.8 days per study year (95% CI 0.2–1.5 days, <italic>P </italic><<italic> </italic>0.001). This did not influence the complication rate over time, however.</p> </sec> <sec id="codi12328-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Factors increasing the risk of complications after emergency colectomy for severe colitis were a higher age, a higher BMI and a longer preoperative hospital stay.</p> </sec> </abstract>