Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

Alaa El-Hussuna, Rikke Nørmark Mortensen, M Frasson, B. Singh, G. Gallo, F. Pata, I. Negoi, ESCP Cohort Studies Committee, ESCP Research Committee, 2015 European Society of Coloproctology (ESCP) collaborating group

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Resumé

BACKGROUND: Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).

AIM: To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.

METHODS: This is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.

RESULTS: Three hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.

CONCLUSION: Patients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications' rate was not different between the two groups.

OriginalsprogEngelsk
TidsskriftWorld Journal of Gastrointestinal Surgery
Vol/bind11
Udgave nummer5
Sider (fra-til)261-270
Antal sider10
ISSN1948-9366
DOI
StatusUdgivet - 27 maj 2019

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Crohn Disease
Colonic Neoplasms
Length of Stay
Anesthesiology
Comorbidity
Outcome Assessment (Health Care)
Multivariate Analysis
Mortality

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El-Hussuna, Alaa ; Mortensen, Rikke Nørmark ; Frasson, M ; Singh, B. ; Gallo, G. ; Pata, F. ; Negoi, I. ; ESCP Cohort Studies Committee ; ESCP Research Committee ; 2015 European Society of Coloproctology (ESCP) collaborating group. / Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate. I: World Journal of Gastrointestinal Surgery. 2019 ; Bind 11, Nr. 5. s. 261-270.
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title = "Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate",
abstract = "BACKGROUND: Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIM: To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODS: This is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTS: Three hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3{\%}). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95{\%}CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95{\%}CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSION: Patients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications' rate was not different between the two groups.",
author = "Alaa El-Hussuna and Mortensen, {Rikke N{\o}rmark} and M Frasson and B. Singh and G. Gallo and F. Pata and I. Negoi and {ESCP Cohort Studies Committee} and {ESCP Research Committee} and {2015 European Society of Coloproctology (ESCP) collaborating group}",
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language = "English",
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pages = "261--270",
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El-Hussuna, A, Mortensen, RN, Frasson, M, Singh, B, Gallo, G, Pata, F, Negoi, I, ESCP Cohort Studies Committee, ESCP Research Committee & 2015 European Society of Coloproctology (ESCP) collaborating group 2019, 'Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate' World Journal of Gastrointestinal Surgery, bind 11, nr. 5, s. 261-270. https://doi.org/10.4240/wjgs.v11.i5.261

Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate. / El-Hussuna, Alaa; Mortensen, Rikke Nørmark; Frasson, M; Singh, B.; Gallo, G.; Pata, F.; Negoi, I.; ESCP Cohort Studies Committee; ESCP Research Committee; 2015 European Society of Coloproctology (ESCP) collaborating group.

I: World Journal of Gastrointestinal Surgery, Bind 11, Nr. 5, 27.05.2019, s. 261-270.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

AU - El-Hussuna, Alaa

AU - Mortensen, Rikke Nørmark

AU - Frasson, M

AU - Singh, B.

AU - Gallo, G.

AU - Pata, F.

AU - Negoi, I.

AU - ESCP Cohort Studies Committee

AU - ESCP Research Committee

AU - 2015 European Society of Coloproctology (ESCP) collaborating group

PY - 2019/5/27

Y1 - 2019/5/27

N2 - BACKGROUND: Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIM: To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODS: This is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTS: Three hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSION: Patients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications' rate was not different between the two groups.

AB - BACKGROUND: Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIM: To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODS: This is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTS: Three hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSION: Patients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications' rate was not different between the two groups.

U2 - 10.4240/wjgs.v11.i5.261

DO - 10.4240/wjgs.v11.i5.261

M3 - Journal article

VL - 11

SP - 261

EP - 270

JO - World Journal of Gastrointestinal Surgery

JF - World Journal of Gastrointestinal Surgery

SN - 1948-9366

IS - 5

ER -