Pubmed- Post-operative morbidity in Crohn's disease: what is the impact of patient-, disease- and surgery-related factors? - IBD Reporter Newsfeed - IBD Support Group Forums - IBDsupport.org

Advertisement

Jump to content


Photo
- - - - -

Pubmed- Post-operative morbidity in Crohn's disease: what is the impact of patient-, disease- and surgery-related factors?


  • Please log in to reply
No replies to this topic

#1 Health Reporter

Health Reporter

    Newsfeeder

  • RSS
  • PipPipPipPip
  • 20943 posts
  • Country:United States

Posted 11 January 2022 - 06:19 PM

Advertisement

Int J Colorectal Dis. 2022 Jan 11. doi: 10.1007/s00384-021-04076-5. Online ahead of print.

ABSTRACT

PURPOSE: Over 50% of patients suffering from Crohn's disease (CD) require surgery in their lifetime. Predictors/risk factors of post-operative morbidity and mortality in CD are poorly investigated. We aimed to assess the risk factors of post-operative morbidity/mortality in CD.

METHODS: We performed a retrospective cohort study in which all CD patients operated and followed up at our tertiary Inflammatory Bowel Disease Centre from 2014 to 2019 were enrolled. For each patient, we evaluated patient-dependent, disease-dependent and surgery-dependent variables. All patients underwent small bowel and/or colic resections.

RESULTS: Of the 165 operated patients, forty-two (25.5%) developed post-operative complications (major complication rate = 9.8%) including wound infection (12.1%), respiratory complications (4.8%), prolonged ileum (4.2%), anastomotic leak (3.6%), urinary infections (3%), abdominal abscess (2.4%), anastomotic bleeding (3.6%), abdominal bleeding (1.2%) and obstruction (0.6%). Two subjects (1.2%) required re-operation within 30 days, and one died. A surgery duration < 141 min was predictive of a better post-operative outcome (sensitivity 80.9%, specificity 43.1%, PPV 32.7%, NPV 86.9%). The multivariable analysis showed stricturing/fistulizing behaviour (OR 3.7, 95% CI 1.6-6.4, p = 0.02), need for total parenteral nutrition (OR 4.1, 95% CI 2.4-9.2, p = 0.01), pre-operative bowel cleansing (OR 0.6, 95% CI 0.41-0.83, p = 0.01) and surgery duration < 141 min (OR 0.2, 95% CI 0.08-0.7, p = 0.03) as the only risk factors associated with post-operative morbidities.

CONCLUSIONS: About 25% of CD patients develop post-operative complications. Several patient-related, disease-related and surgery-related factors should be considered risk factors for post-operative morbidity. The recognition of these factors, as well as a multidisciplinary approach to the pre-operative management of CD, could reduce post-operative complications.

PMID:35013822 | DOI:10.1007/s00384-021-04076-5


View the full article


Advertisement




© Copyright 1995-2014 IBD Support All rights reserved.

About Us | Contact Us | Advertise With Us | Disclaimer | Terms of Service | Crisis Resources

This website is certified by Health On the Net Foundation. Click to verify. We comply with the HONcode standard for trustworthy health information: verify here