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Am J Surg. 2014 Nov;208(5):749-55. doi: 10.1016/j.amjsurg.2014.04.010. Epub 2014 Jun 27.

Organ space infection following ileocolectomy for Crohn's disease: a National Surgical Quality Improvement Project study.

Author information

1
Division of Colon and Rectal Surgery, Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
2
Division of Colon and Rectal Surgery, Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
3
Division of Colon and Rectal Surgery, Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA. Electronic address: emessaris@hmc.psu.edu.

Abstract

BACKGROUND:

Organ space infection (OSI) rates post ileocolectomy for Crohn's disease are relatively high. The aim of this study was to determine which factors predispose to OSI in this patient cohort.

METHODS:

Data for 2,618 Crohn's patients undergoing ileocolectomy between 2005 and 2011 were obtained from the American College of Surgeons National Surgical Quality Improvement Project database. Primary outcome was an OSI within 30 days of discharge. Univariate analysis using chi-square and Student t tests and a logistic multivariate analysis were performed.

RESULTS:

Preoperative weight loss (odds ratio [OR] 2.11, P = .002), extended operating time (OR 1.57, P = .016), open procedures (OR 1.47, P = .043), and contaminated/dirty wounds (OR 1.95, P = .008) conferred an increased risk for OSI on multivariate analysis. Rates of stoma creation and steroid use were not significantly different between the groups.

CONCLUSIONS:

Weight loss is a preoperative, potentially modifiable variable associated with OSI in Crohn's patients undergoing ileocolectomy and OSI-associated operative factors which may be noted to identify high-risk patients include extended operating time and open procedures.

KEYWORDS:

Abscess; Anastomotic complication; Crohn's disease; Ileocolectomy; Organ space infection

PMID:
25096262
DOI:
10.1016/j.amjsurg.2014.04.010
[Indexed for MEDLINE]
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