Readmission for Dehydration or Renal Failure After Ileostomy Creation

Paquette, Ian M.; Solan, Patrick D.; Rafferty, Janice F.; Ferguson, Martha A.; Davis, Bradley R.

doi:10.1097/dcr.0b013e31828d02ba

Cited by 127 publications

(119 citation statements)

References 22 publications

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“…The most common etiologies for readmission include postoperative infection, renal failure, and dehydration. The readmission rate for dehydration or renal failure within 30 days following ileostomy creation ranges from 17 to 36%, and an age of >50 years is an independent predictor of readmission for renal failure [15]. Consistent with our findings, the aforementioned observations indicate that ileostomy more frequently leads to renal insufficiency than colostomy does and significantly increases the readmission rate.…”

Section: Discussionsupporting

confidence: 88%

Early closure of defunctioning stoma increases complications related to stoma closure after concurrent chemoradiotherapy and low anterior resection in patients with rectal cancer

et al. 2017

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BackgroundAfter a low anterior resection, creating a defunctioning stoma is vital for securing the anastomosis in low-lying rectal cancer patients receiving concurrent chemoradiotherapy. Although it decreases the complication and reoperation rates associated with anastomotic leakage, the complications that arise before and after stoma closure should be carefully evaluated and managed.MethodsThis study enrolled 95 rectal cancer patients who received neoadjuvant concurrent chemoradiotherapy and low anterior resection with anastomosis of the bowel between July 2010 and November 2012. A defunctioning stoma was created in 63 patients during low anterior resection and in another three patients after anastomotic leakage.ResultsThe total complication rate from stoma creation to closure was 36.4%. Ileostomy led to greater renal insufficiency than colostomy did and significantly increased the readmission rate (all p < 0.05). The complication rate related to stoma closure was 36.0%. Patients with ileostomy had an increased risk of developing complications (p = 0.017), and early closure of the defunctioning stoma yielded a higher incidence of morbidity (p = 0.006). Multivariate analysis revealed that a time to closure of ≤109 days was an independent risk factor for developing complications (p = 0.007).ConclusionsThe optimal timing of stoma reversal is at least 109 days after stoma construction in rectal cancer patients receiving concurrent chemoradiotherapy and low anterior resection.

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Section: Discussionsupporting

confidence: 88%

Early closure of defunctioning stoma increases complications related to stoma closure after concurrent chemoradiotherapy and low anterior resection in patients with rectal cancer

et al. 2017

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“…Hanzlik et al have suggested that protocolized peri-operative teaching, such as the "Ileostomy pathway" which has been shown to reduce readmission rates in patients with new ostomies should be adopted in these cases. 16,17,22,[24][25][26][27] Of the post-operative complications, renal complications and urinary tract infections (7.6% each), were found to be significant risk factors for readmission and the similar findings were observed by Kassin et al as well. 3 Kelly et al also found that UTI was a significant factor for readmission.…”

Section: Discussionsupporting

confidence: 76%

Risk factors for 30-day unplanned readmission among patients undergoing laparotomy for perforation peritonitis

et al. 2017

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Background: Unforeseen re-admissions are a consequence of natural course of patient’s disease or results from sub-optimal care during first admission. Apart from causing increased expenditure, readmission immensely adds to the distress of the patient as well as his relatives. The aim of the study was to assess the incidence and risk factors for 30-day unplanned readmission following emergency laparotomy for perforation peritonitis.Methods: This prospective observational study was conducted on 145 patients undergoing laparotomy for perforation peritonitis in over a period of two years. Various pre-operative, intra-operative and post-operative parameters were studied to identify the risk factors for readmission.Results: Overall readmission rate was 8.96% and in majority of the cases it was due to post-surgical complications. Various factors found significant for readmission were American Society of Anaesthesiology (ASA) grade (p = 0.014) hypoproteinemia (p<0.001), diabetes mellitus (p = 0.001), immuno compromised status (p<0.001), stoma creation (p<0.001), blood transfusion (p = 0.022), renal complications and UTI (p = 0.027 each). On multivariate analysis, hypoproteinemia and stoma creation were found to be significant.Conclusions: Risk factors for readmission among surgical patients are multi-factorial. Taking appropriate steps can reduce the burden of readmission. Moreover decreasing the rate of surgical readmission represents an opportunity to improve patient care.

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“…Current literature reports adult readmission rates for dehydration after ileostomy creation near 20% [15]. Therefore, we do not appreciate a statistical or clinical difference between cohorts regarding rate of dehydration.…”

Section: Accepted Manuscriptmentioning

confidence: 85%

Surgical outcomes, bowel habits and quality of life in young patients after ileoanal anastomosis for ulcerative colitis

Knod

Holder

Cortez

et al. 2016

Journal of Pediatric Surgery

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Readmission for Dehydration or Renal Failure After Ileostomy Creation

Abstract: Hospital readmission due to dehydration or renal failure following ileostomy creation is common, with age >50 being the strongest predictor for renal failure. Appropriate strategies to decrease dehydration and renal failure following ileostomy creation need to be investigated.

Cited by 127 publications

References 22 publications

Early closure of defunctioning stoma increases complications related to stoma closure after concurrent chemoradiotherapy and low anterior resection in patients with rectal cancer

Early closure of defunctioning stoma increases complications related to stoma closure after concurrent chemoradiotherapy and low anterior resection in patients with rectal cancer

Risk factors for 30-day unplanned readmission among patients undergoing laparotomy for perforation peritonitis

Surgical outcomes, bowel habits and quality of life in young patients after ileoanal anastomosis for ulcerative colitis

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