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Assessment of Risk Factors for the Occurrence of a High-Output Ileostomy
Background: Ileostomy is often required in patients undergoing bowel resections for inflammatory bowel diseases (IBD), colorectal cancer, and emergencies. Unfortunately, some patients develop a high-output stoma (HOS). This condition affects homeostasis and may be life threatening. We aimed to ident...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176110/ https://www.ncbi.nlm.nih.gov/pubmed/34095201 http://dx.doi.org/10.3389/fsurg.2021.642288 |
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author | Seifarth, Claudia Augustin, Leonard N. Lehmann, Kai S. Stroux, Andrea Lauscher, Johannes C. Kreis, Martin E. Holmer, Christoph |
author_facet | Seifarth, Claudia Augustin, Leonard N. Lehmann, Kai S. Stroux, Andrea Lauscher, Johannes C. Kreis, Martin E. Holmer, Christoph |
author_sort | Seifarth, Claudia |
collection | PubMed |
description | Background: Ileostomy is often required in patients undergoing bowel resections for inflammatory bowel diseases (IBD), colorectal cancer, and emergencies. Unfortunately, some patients develop a high-output stoma (HOS). This condition affects homeostasis and may be life threatening. We aimed to identify possible risk factors for the development of HOS. Patients and methods: From 2012 to 2018, 296 patients who underwent ileostomy at Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin were retrospectively analyzed. Emergency operations were included. Diverting ileostomy, end ileostomies and anastomotic stomata with at least part ileum, were examined. HOS was defined as stoma output of more than 1,000 mL per day for more than 3 days. Univariate and multivariable analyses were used to detect potential risk factors for the development of HOS. Results: 41 of 296 patients developed HOS (13.9%). Mortality was 0.3%. In the univariate analysis, age (p < 0.002), diagnosis (Crohn's disease, p = 0.005), arterial hypertension (p = 0.023), surgical procedure (right-sided colectomy, small bowel resection, p < 0.001), open technique (p < 0.002), emergencies (p = 0.014), and anastomotic ileostomy (p < 0.001) were identified as risk factors. In the multivariable logistic regression, older age, diagnosis (Crohn's disease) and surgical procedure (right-sided colectomy, separate ileostomy, small bowel resection) remained significant risk factors. Conclusion: The occurrence of HOS is a relevant problem after ileostomy. The identification of risk factors for a high-output may be helpful for monitoring, early diagnosis and initiation of therapy as well as in the planning of close follow-up care. |
format | Online Article Text |
id | pubmed-8176110 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81761102021-06-05 Assessment of Risk Factors for the Occurrence of a High-Output Ileostomy Seifarth, Claudia Augustin, Leonard N. Lehmann, Kai S. Stroux, Andrea Lauscher, Johannes C. Kreis, Martin E. Holmer, Christoph Front Surg Surgery Background: Ileostomy is often required in patients undergoing bowel resections for inflammatory bowel diseases (IBD), colorectal cancer, and emergencies. Unfortunately, some patients develop a high-output stoma (HOS). This condition affects homeostasis and may be life threatening. We aimed to identify possible risk factors for the development of HOS. Patients and methods: From 2012 to 2018, 296 patients who underwent ileostomy at Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin were retrospectively analyzed. Emergency operations were included. Diverting ileostomy, end ileostomies and anastomotic stomata with at least part ileum, were examined. HOS was defined as stoma output of more than 1,000 mL per day for more than 3 days. Univariate and multivariable analyses were used to detect potential risk factors for the development of HOS. Results: 41 of 296 patients developed HOS (13.9%). Mortality was 0.3%. In the univariate analysis, age (p < 0.002), diagnosis (Crohn's disease, p = 0.005), arterial hypertension (p = 0.023), surgical procedure (right-sided colectomy, small bowel resection, p < 0.001), open technique (p < 0.002), emergencies (p = 0.014), and anastomotic ileostomy (p < 0.001) were identified as risk factors. In the multivariable logistic regression, older age, diagnosis (Crohn's disease) and surgical procedure (right-sided colectomy, separate ileostomy, small bowel resection) remained significant risk factors. Conclusion: The occurrence of HOS is a relevant problem after ileostomy. The identification of risk factors for a high-output may be helpful for monitoring, early diagnosis and initiation of therapy as well as in the planning of close follow-up care. Frontiers Media S.A. 2021-05-21 /pmc/articles/PMC8176110/ /pubmed/34095201 http://dx.doi.org/10.3389/fsurg.2021.642288 Text en Copyright © 2021 Seifarth, Augustin, Lehmann, Stroux, Lauscher, Kreis and Holmer. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Seifarth, Claudia Augustin, Leonard N. Lehmann, Kai S. Stroux, Andrea Lauscher, Johannes C. Kreis, Martin E. Holmer, Christoph Assessment of Risk Factors for the Occurrence of a High-Output Ileostomy |
title | Assessment of Risk Factors for the Occurrence of a High-Output Ileostomy |
title_full | Assessment of Risk Factors for the Occurrence of a High-Output Ileostomy |
title_fullStr | Assessment of Risk Factors for the Occurrence of a High-Output Ileostomy |
title_full_unstemmed | Assessment of Risk Factors for the Occurrence of a High-Output Ileostomy |
title_short | Assessment of Risk Factors for the Occurrence of a High-Output Ileostomy |
title_sort | assessment of risk factors for the occurrence of a high-output ileostomy |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176110/ https://www.ncbi.nlm.nih.gov/pubmed/34095201 http://dx.doi.org/10.3389/fsurg.2021.642288 |
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