Prolonged preoperative hospital stay is a risk factor for complications after emergency colectomy for severe colitis

Colorectal Dis. 2013 Nov;15(11):1392-8. doi: 10.1111/codi.12328.

Abstract

Aim: 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.

Method: 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.

Results: 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 vs 35 years, P = 0.020) and a higher body mass index (BMI) (mean 25.9 vs 21.0 kg/m(2), P = 0.006). Length of preoperative hospital stay (median 15 vs 6 days, P = 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, P < 0.001). This did not influence the complication rate over time, however.

Conclusion: 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.

Keywords: Inflammatory bowel disease; gastroenterology; surgery.

MeSH terms

  • Acute Disease
  • Adult
  • Age Factors
  • Body Mass Index
  • Colectomy / adverse effects*
  • Colitis / etiology
  • Colitis / surgery*
  • Colitis, Ulcerative / surgery
  • Crohn Disease / complications
  • Crohn Disease / surgery*
  • Emergencies
  • Female
  • Humans
  • Ileostomy / adverse effects
  • Length of Stay*
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Preoperative Period*
  • Retrospective Studies
  • Risk Factors
  • Young Adult