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Factors Associated with Short-Term Morbidity in Patients Undergoing Colon Resection for Crohn’s Disease

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Patients undergoing colon resection for Crohn’s disease are at risk of developing postoperative complications. The aim of this study is to identify factors associated with short-term (30-day) morbidity in patients undergoing colon resection for Crohn’s disease from a national database.

Methods

Patients who underwent colon resection for Crohn’s disease in 2015 were identified from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. The groups were classified based on presence of postoperative 30-day complications. The overall morbidity was calculated by including patients who had at least one postoperative complication. Demographics, preoperative, and operative factors were assessed and compared between the two groups. Further multivariate logistic regression analysis was conducted.

Results

A total of 1643 patients met the inclusion criteria [mean age of 41.2 (± 15.5) years, 871 (53%) female]. Sixty percent (n = 993) of the procedures were performed laparoscopically and 128 (12.8%) cases were converted to open. Ninety-five patients (5%) underwent emergent resections. Thirty percent (n = 507) of patients had at least one postoperative complication within 30 days of surgery. Ileus (16%), transfusion (7%), and organ-space surgical site infection (6%) were the most common morbidities. Independent risk factors for postoperative morbidity were male gender (p = 0.01), open surgery (p = 0.002), preoperative severe anemia (p = 0.001), and preoperative weight loss (p = 0.04).

Conclusion

Approximately one third of the patients who undergo colon resection for Crohn’s disease experience postoperative complications. Preoperative optimization of nutrition and anemia may improve outcomes. Laparoscopic technique appears to be the preferred surgical treatment option for resection when feasible.

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Contributions

All the authors contributed to the conception or design of the project; assisted with the acquisition, analysis, or interpretation of data; drafted and/or revised the manuscript; and had final approval of the version to be published. All the authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity may be resolved.

Corresponding author

Correspondence to Alexis L. Grucela.

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The authors have no conflicts of interest including relevant financial interests, activities, relationships, and affiliations.

State

The preliminary results of the study were presented as poster at the American Society of Colon and Rectal Surgery Annual Scientific Meeting, June 10–14, 2017, Seattle, WA.

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Aydinli, H.H., Aytac, E., Remzi, F.H. et al. Factors Associated with Short-Term Morbidity in Patients Undergoing Colon Resection for Crohn’s Disease. J Gastrointest Surg 22, 1434–1441 (2018). https://doi.org/10.1007/s11605-018-3763-4

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