학술논문

Patient-related factors influence the risk of developing intestinal stoma complications in early post-operative period.
Document Type
Article
Source
ANZ Journal of Surgery. Oct2017, Vol. 87 Issue 10, pE116-E120. 5p. 3 Charts.
Subject
*ENTEROSTOMY
*REGRESSION analysis
*OVERWEIGHT persons
*INTESTINAL diseases
*DISEASE risk factors
*DISEASES
SURGICAL complication risk factors
Language
ISSN
1445-1433
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. [ABSTRACT FROM AUTHOR]