TY - JOUR
T1 - Predisposing factors for high output stoma in patients with a diverting loop ileostomy after colorectal surgeries
AU - Assaf, Dan
AU - Hazzan, David
AU - Ben-Yaacov, Almog
AU - Laks, Shachar
AU - Zippel, Douglas
AU - Segev, Lior
N1 - Publisher Copyright:
© 2023 The Korean Society of Coloproctology.
PY - 2023
Y1 - 2023
N2 - Purpose: One of the most common ileostomy-related complications is high output stoma (HOS) which causes significant fluids and electrolytes disturbances. We aimed to analyze the incidence, severity, and risk factors for readmission for HOS. Methods: We reviewed all patients who underwent loop ileostomy closure in a single institution between 2010 and 2020. Patients that were readmitted for dehydration due to HOS during the time interval between the creation and the closure of the stoma were identified and divided into a study (HOS) group. The remaining patients constructed the control group. Results: A total of 307 patients were included in this study, out of which, 41 patients were readmitted 73 times (23.7% readmission rate) for the HOS group, and the remaining 266 patients constructed the control group. Multivariate analysis identified; advanced American Society of Anesthesiologists (ASA) physical status (PS) classification, elevated baseline creatinine, and open surgery as risk factors for HOS. Renal function worsened among the entire cohort between the construction of the stoma to its closure (mean creatinine of 0.82 vs. 0.96, P<0.0001). Conclusion: Loop ileostomy formation is associated with a substantial readmission rate for dehydration as a result of HOS, and increasing the risk for renal impairment during the duration of the diversion. We identified advanced ASA PS classification, open surgery, and elevated baseline creatinine as predictors for HOS.
AB - Purpose: One of the most common ileostomy-related complications is high output stoma (HOS) which causes significant fluids and electrolytes disturbances. We aimed to analyze the incidence, severity, and risk factors for readmission for HOS. Methods: We reviewed all patients who underwent loop ileostomy closure in a single institution between 2010 and 2020. Patients that were readmitted for dehydration due to HOS during the time interval between the creation and the closure of the stoma were identified and divided into a study (HOS) group. The remaining patients constructed the control group. Results: A total of 307 patients were included in this study, out of which, 41 patients were readmitted 73 times (23.7% readmission rate) for the HOS group, and the remaining 266 patients constructed the control group. Multivariate analysis identified; advanced American Society of Anesthesiologists (ASA) physical status (PS) classification, elevated baseline creatinine, and open surgery as risk factors for HOS. Renal function worsened among the entire cohort between the construction of the stoma to its closure (mean creatinine of 0.82 vs. 0.96, P<0.0001). Conclusion: Loop ileostomy formation is associated with a substantial readmission rate for dehydration as a result of HOS, and increasing the risk for renal impairment during the duration of the diversion. We identified advanced ASA PS classification, open surgery, and elevated baseline creatinine as predictors for HOS.
KW - Dehydration
KW - Ileostomy
KW - Patient readmission
UR - http://www.scopus.com/inward/record.url?scp=85163428798&partnerID=8YFLogxK
U2 - 10.3393/ac.2021.00241.0034
DO - 10.3393/ac.2021.00241.0034
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C2 - 34364318
AN - SCOPUS:85163428798
SN - 2287-9714
VL - 39
SP - 168
EP - 174
JO - Annals of Coloproctology
JF - Annals of Coloproctology
IS - 2
ER -