Colectomy and the incidence of postsurgical complications among ulcerative colitis patients with private health insurance in the United States

Edward Vincent Loftus, Jr, David J. Delgado, Howard S. Friedman, William J. Sandborn

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

PURPOSE: We sought to describe the types of colectomy, follow-up surgical/diagnostic procedures, and complications occurring within 180 days of colectomy in a population of privately insured individuals with ulcerative colitis (UC).METHODS: This was a retrospective analysis of claims data of privately insured patients (MarketScan) for the years 2001-2004. We identified a cohort of patients with UC who underwent colectomy. Colectomies were classified into four categories based on the surgery occurring on the first colectomy date: (a) total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA), (b) subtotal colectomy (SC) with ileostomy and Hartmann pouch or ileorectal anastomosis, (c) TPC with ileostomy, and (d) partial colectomy (PC). Follow-up surgical/diagnostic procedures and complications were compared across colectomy categories.RESULTS: A total of 25,586 UC patients were identified, of whom 215 patients had a colectomy and at least 180 days of pre- and postcolectomy follow-up. The colectomy distribution was: TPC-IPAA (52%), SC-ileostomy (22%), TPC-ileostomy (14%), and PC (13%). Within 180 days postcolectomy, 54% of patients had a second colectomy-related surgery (including unplanned surgeries in 15.3%), and 27% had a follow-up diagnostic procedure. Postcolectomy complications included abscesses (11.6% in the first 30 days postcolectomy, 16.3% in the day 31-180 postcolectomy period), fistulas (4.2% early, 6.0% late), and sepsis/pneumonia/bacteremia (7.9% early, 9.3% late).CONCLUSION: Postcolectomy surgical procedures and complications occur frequently after colectomy in privately insured patients with UC.

Original languageEnglish (US)
Pages (from-to)1737-1745
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume103
Issue number7
DOIs
StatePublished - Jul 2008

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Colectomy
Health Insurance
Ulcerative Colitis
Incidence
Ileostomy
Colonic Pouches
Insurance Claim Review
Bacteremia
Abscess
Fistula
Sepsis
Pneumonia

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Colectomy and the incidence of postsurgical complications among ulcerative colitis patients with private health insurance in the United States. / Loftus, Jr, Edward Vincent; Delgado, David J.; Friedman, Howard S.; Sandborn, William J.

In: American Journal of Gastroenterology, Vol. 103, No. 7, 07.2008, p. 1737-1745.

Research output: Contribution to journalArticle

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abstract = "PURPOSE: We sought to describe the types of colectomy, follow-up surgical/diagnostic procedures, and complications occurring within 180 days of colectomy in a population of privately insured individuals with ulcerative colitis (UC).METHODS: This was a retrospective analysis of claims data of privately insured patients (MarketScan) for the years 2001-2004. We identified a cohort of patients with UC who underwent colectomy. Colectomies were classified into four categories based on the surgery occurring on the first colectomy date: (a) total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA), (b) subtotal colectomy (SC) with ileostomy and Hartmann pouch or ileorectal anastomosis, (c) TPC with ileostomy, and (d) partial colectomy (PC). Follow-up surgical/diagnostic procedures and complications were compared across colectomy categories.RESULTS: A total of 25,586 UC patients were identified, of whom 215 patients had a colectomy and at least 180 days of pre- and postcolectomy follow-up. The colectomy distribution was: TPC-IPAA (52{\%}), SC-ileostomy (22{\%}), TPC-ileostomy (14{\%}), and PC (13{\%}). Within 180 days postcolectomy, 54{\%} of patients had a second colectomy-related surgery (including unplanned surgeries in 15.3{\%}), and 27{\%} had a follow-up diagnostic procedure. Postcolectomy complications included abscesses (11.6{\%} in the first 30 days postcolectomy, 16.3{\%} in the day 31-180 postcolectomy period), fistulas (4.2{\%} early, 6.0{\%} late), and sepsis/pneumonia/bacteremia (7.9{\%} early, 9.3{\%} late).CONCLUSION: Postcolectomy surgical procedures and complications occur frequently after colectomy in privately insured patients with UC.",
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N2 - PURPOSE: We sought to describe the types of colectomy, follow-up surgical/diagnostic procedures, and complications occurring within 180 days of colectomy in a population of privately insured individuals with ulcerative colitis (UC).METHODS: This was a retrospective analysis of claims data of privately insured patients (MarketScan) for the years 2001-2004. We identified a cohort of patients with UC who underwent colectomy. Colectomies were classified into four categories based on the surgery occurring on the first colectomy date: (a) total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA), (b) subtotal colectomy (SC) with ileostomy and Hartmann pouch or ileorectal anastomosis, (c) TPC with ileostomy, and (d) partial colectomy (PC). Follow-up surgical/diagnostic procedures and complications were compared across colectomy categories.RESULTS: A total of 25,586 UC patients were identified, of whom 215 patients had a colectomy and at least 180 days of pre- and postcolectomy follow-up. The colectomy distribution was: TPC-IPAA (52%), SC-ileostomy (22%), TPC-ileostomy (14%), and PC (13%). Within 180 days postcolectomy, 54% of patients had a second colectomy-related surgery (including unplanned surgeries in 15.3%), and 27% had a follow-up diagnostic procedure. Postcolectomy complications included abscesses (11.6% in the first 30 days postcolectomy, 16.3% in the day 31-180 postcolectomy period), fistulas (4.2% early, 6.0% late), and sepsis/pneumonia/bacteremia (7.9% early, 9.3% late).CONCLUSION: Postcolectomy surgical procedures and complications occur frequently after colectomy in privately insured patients with UC.

AB - PURPOSE: We sought to describe the types of colectomy, follow-up surgical/diagnostic procedures, and complications occurring within 180 days of colectomy in a population of privately insured individuals with ulcerative colitis (UC).METHODS: This was a retrospective analysis of claims data of privately insured patients (MarketScan) for the years 2001-2004. We identified a cohort of patients with UC who underwent colectomy. Colectomies were classified into four categories based on the surgery occurring on the first colectomy date: (a) total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA), (b) subtotal colectomy (SC) with ileostomy and Hartmann pouch or ileorectal anastomosis, (c) TPC with ileostomy, and (d) partial colectomy (PC). Follow-up surgical/diagnostic procedures and complications were compared across colectomy categories.RESULTS: A total of 25,586 UC patients were identified, of whom 215 patients had a colectomy and at least 180 days of pre- and postcolectomy follow-up. The colectomy distribution was: TPC-IPAA (52%), SC-ileostomy (22%), TPC-ileostomy (14%), and PC (13%). Within 180 days postcolectomy, 54% of patients had a second colectomy-related surgery (including unplanned surgeries in 15.3%), and 27% had a follow-up diagnostic procedure. Postcolectomy complications included abscesses (11.6% in the first 30 days postcolectomy, 16.3% in the day 31-180 postcolectomy period), fistulas (4.2% early, 6.0% late), and sepsis/pneumonia/bacteremia (7.9% early, 9.3% late).CONCLUSION: Postcolectomy surgical procedures and complications occur frequently after colectomy in privately insured patients with UC.

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