Risk factors for complications after bowel surgery in Korean patients with Crohn's disease.
10.4174/jkss.2012.83.3.141
- Author:
Song Soo YANG
1
;
Chang Sik YU
;
Yong Sik YOON
;
Sang Nam YOON
;
Seok Byung LIM
;
Jin Cheon KIM
Author Information
1. Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. csyu@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Crohn disease;
Surgery;
Korea;
Risk factors;
Postoperative complications
- MeSH:
Anemia;
Crohn Disease;
Emergencies;
Humans;
Hypoalbuminemia;
Incidence;
Korea;
Length of Stay;
Male;
Multivariate Analysis;
Odds Ratio;
Postoperative Complications;
Retrospective Studies;
Risk Factors;
Wound Infection
- From:Journal of the Korean Surgical Society
2012;83(3):141-148
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To assess the incidence and factors predictive of early postoperative complications in Korean patients who undergo surgery for Crohn's disease (CD). METHODS: We retrospectively assessed 350 patients (246 males, 104 females; mean age, 30 +/- 9 years) who underwent surgery for primary or recurrent CD at Asan Medical Center between January 1991 and May 2010. The incidence and predictive factors of early postoperative complications were analyzed by both univariate and multivariate analyses. RESULTS: Of the 350 patients, 81 patients (23.1%) developed postoperative complications, the most common being septic complications (54 patients), including 19 cases of wound infection. Thirty patients (8.6%) required re-operations, and only one patient died. Multivariate analysis showed that four factors were independently associated with a high risk of early postoperative complications; preoperative moderate to severe anemia (hematocrit concentration <30%; odds ratio [OR], 3.1; 95% confidence interval [CI], 1.6 to 5.9), hypoalbuminemia (serum albumin level <3.0 g/dL; OR, 2.6; 95% CI, 1.4 to 4.7), emergency surgery (OR, 4.0; 95% CI, 1.5 to 10.6), and covering stoma (OR, 2.6; 95% CI, 1.3 to 5.4). Correction of preoperative moderate to severe anemia and hypoalbuminemia decreased the incidence of postoperative complications. Mean hospital stay was significantly longer in patients with than without postoperative complications (31.3 +/- 27.2 days vs. 10.3 +/- 3.8 days, P < 0.001). CONCLUSION: Preoperative anemia, low albumin level, emergency surgery, and covering stoma significantly increased the risk of early postoperative complications in patients with CD. Correcting preoperatively deficient nutritional factors may reduce postoperative morbidities.
