TY - JOUR
T1 - Risk factors for organ space infection after ileal pouch anal anastomosis for chronic ulcerative colitis
T2 - An ACS NSQIP analysis
AU - McKenna, Nicholas P.
AU - Glasgow, Amy E.
AU - Cima, Robert R.
AU - Habermann, Elizabeth B.
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/11
Y1 - 2018/11
N2 - Background: Organ space infection (OSI) after ileal pouch anal anastomosis (IPAA) is a devastating complication. The aim of this was study was to determine separately risk factors for OSI after total proctocolectomy (TPC) with IPAA and completion proctectomy (CP) with IPAA. Methods: 4049 patients with a diagnosis of chronic ulcerative colitis undergoing TPC with IPAA or CP with IPAA between 2005 and 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program database. Primary outcome was an OSI within 30 days of surgery. Multivariable analyses were conducted for the development of OSI after each operation. Results: For TPC with IPAA, urgent surgery (OR: 2.0, p < 0.01) and obesity (OR: 1.6, p < 0.01) were independent risk factors for OSI. Operation length of 275 + minutes (versus <170 min; OR: 2.2, p = 0.02) was predictive of OSI after CP with IPAA. Conclusion: Risk factors for OSI differed between the operations. This highlights the importance of the consideration of the physiologic status of the patient when deciding to perform TPC with IPAA or subtotal colectomy with ileostomy initially.
AB - Background: Organ space infection (OSI) after ileal pouch anal anastomosis (IPAA) is a devastating complication. The aim of this was study was to determine separately risk factors for OSI after total proctocolectomy (TPC) with IPAA and completion proctectomy (CP) with IPAA. Methods: 4049 patients with a diagnosis of chronic ulcerative colitis undergoing TPC with IPAA or CP with IPAA between 2005 and 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program database. Primary outcome was an OSI within 30 days of surgery. Multivariable analyses were conducted for the development of OSI after each operation. Results: For TPC with IPAA, urgent surgery (OR: 2.0, p < 0.01) and obesity (OR: 1.6, p < 0.01) were independent risk factors for OSI. Operation length of 275 + minutes (versus <170 min; OR: 2.2, p = 0.02) was predictive of OSI after CP with IPAA. Conclusion: Risk factors for OSI differed between the operations. This highlights the importance of the consideration of the physiologic status of the patient when deciding to perform TPC with IPAA or subtotal colectomy with ileostomy initially.
KW - Chronic ulcerative colitis
KW - IPAA
KW - NSQIP
KW - Organ space infection
UR - http://www.scopus.com/inward/record.url?scp=85043325867&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85043325867&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2018.02.030
DO - 10.1016/j.amjsurg.2018.02.030
M3 - Article
C2 - 29534812
AN - SCOPUS:85043325867
SN - 0002-9610
VL - 216
SP - 900
EP - 905
JO - American journal of surgery
JF - American journal of surgery
IS - 5
ER -