Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection. An international audit by ESCP and S-ECCO

2015 European Society of Coloproctology collaborating group, Alaa El-Hussuna (Medlem af forfattergruppering), Rikke Nørmark Mortensen (Medlem af forfattergruppering)

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

10 Citationer (Scopus)

Resumé

AimPatient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. MethodThis was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95% confidence intervals. ResultsIn all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10-4.97), urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13-3.55) and unplanned intra-operative adverse events (OR 2.30, 95% CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95% CI 1.08-1.61) and those who had urgent/expedited operations (OR 1.21, 95% CI 1.07-1.37). ConclusionPreoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients.
OriginalsprogEngelsk
TidsskriftColorectal Disease
Vol/bind20
Udgave nummer3
Sider (fra-til)219-227
Antal sider9
ISSN1462-8910
DOI
StatusUdgivet - 1 mar. 2018

Citer dette

@article{ffa1136598b74dcb931c7014dd081901,
title = "Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection. An international audit by ESCP and S-ECCO",
abstract = "AimPatient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. MethodThis was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95{\%} confidence intervals. ResultsIn all, 375 resections in 375 patients were included. The median age was 37 and 57.1{\%} were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95{\%} CI 1.10-4.97), urgent/expedited surgical intervention (OR 2.00, 95{\%} CI 1.13-3.55) and unplanned intra-operative adverse events (OR 2.30, 95{\%} CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95{\%} CI 1.08-1.61) and those who had urgent/expedited operations (OR 1.21, 95{\%} CI 1.07-1.37). ConclusionPreoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients.",
keywords = "Crohn's disease, surgery, resection, postoperative complications, outcome, parenteral nutrition",
author = "{2015 European Society of Coloproctology collaborating group} and Alaa El-Hussuna and Mortensen, {Rikke N{\o}rmark}",
year = "2018",
month = "3",
day = "1",
doi = "10.1111/codi.13889",
language = "English",
volume = "20",
pages = "219--227",
journal = "Colorectal Disease",
issn = "1462-8910",
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TY - JOUR

T1 - Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection. An international audit by ESCP and S-ECCO

AU - 2015 European Society of Coloproctology collaborating group

A2 - El-Hussuna, Alaa

A2 - Mortensen, Rikke Nørmark

PY - 2018/3/1

Y1 - 2018/3/1

N2 - AimPatient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. MethodThis was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95% confidence intervals. ResultsIn all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10-4.97), urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13-3.55) and unplanned intra-operative adverse events (OR 2.30, 95% CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95% CI 1.08-1.61) and those who had urgent/expedited operations (OR 1.21, 95% CI 1.07-1.37). ConclusionPreoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients.

AB - AimPatient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. MethodThis was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95% confidence intervals. ResultsIn all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10-4.97), urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13-3.55) and unplanned intra-operative adverse events (OR 2.30, 95% CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95% CI 1.08-1.61) and those who had urgent/expedited operations (OR 1.21, 95% CI 1.07-1.37). ConclusionPreoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients.

KW - Crohn's disease

KW - surgery

KW - resection

KW - postoperative complications

KW - outcome

KW - parenteral nutrition

UR - http://www.scopus.com/inward/record.url?scp=85042633058&partnerID=8YFLogxK

U2 - 10.1111/codi.13889

DO - 10.1111/codi.13889

M3 - Journal article

VL - 20

SP - 219

EP - 227

JO - Colorectal Disease

JF - Colorectal Disease

SN - 1462-8910

IS - 3

ER -