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World Journal of Surgery

, Volume 37, Issue 2, pp 333–338 | Cite as

Colectomy in Intensive Care Patients: Operative Findings and Outcomes

  • Seija SipolaEmail author
  • Hannu Syrjälä
  • Vesa Koivukangas
  • Jouko J. Laurila
  • Tuomo Karttunen
  • Pasi Ohtonen
  • Juha Saarnio
  • Tero I. Ala-Kokko
Article

Abstract

Background

With a critical illness, intestinal complications are associated with high morbidity and mortality.

Methods

Operative findings and outcomes of 77 intensive care unit (ICU) patients treated with colectomy are described.

Results

Three conditions led to colectomy: sepsis (S group; n = 31), fulminant Clostridium difficile colitis (Cl group; n = 25), and cardiovascular surgery (CV group; n = 21). The median Acute Physiology and Chronic Health score was >25 in all groups. Thickening and distension of the colon was more frequent in the Cl group (p = 0.001), and ischemia was more frequent in the S and CV groups (p < 0.001). Widespread necrosis was more frequent in the CV patients (p = 0.001). The kappa value for ischemic operative findings and histologic necrosis was 0.64 (95 % confidence interval 0.49–0.79). Hospital mortality was 35 % without multiple organ failure (MOF) (n = 31) and 74 % with MOF (n = 46) (p < 0.001). Overall, 38 % were alive at the 1-year follow-up.

Conclusions

Although colectomy in ICU patients is associated with high hospital mortality, patients who survive beyond their hospital stay have a good 1-year outcome

Keywords

Intensive Care Unit Patient Clostridium Difficile Infection Multiple Organ Failure Ischemic Colitis Pseudomembranous Colitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Seija Sipola
    • 1
    Email author
  • Hannu Syrjälä
    • 2
  • Vesa Koivukangas
    • 3
  • Jouko J. Laurila
    • 1
  • Tuomo Karttunen
    • 4
  • Pasi Ohtonen
    • 3
  • Juha Saarnio
    • 3
  • Tero I. Ala-Kokko
    • 1
  1. 1.Department of Anaesthesiology, Division of Intensive Care MedicineOulu University HospitalOuluFinland
  2. 2.Department of Infection ControlOulu University HospitalOuluFinland
  3. 3.Department of SurgeryOulu University HospitalOuluFinland
  4. 4.Department of PathologyOulu University HospitalOuluFinland

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