J Korean Surg Soc.  2012 Sep;83(3):141-148. 10.4174/jkss.2012.83.3.141.

Risk factors for complications after bowel surgery in Korean patients with Crohn's disease

• Yang SS
• Yu CS
• Yoon YS
• Yoon SN
• Lim SB
• Kim JC

• KMID: 2212286
• DOI: http://doi.org/10.4174/jkss.2012.83.3.141

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.

Keyword

Crohn disease; Surgery; Korea; Risk factors; Postoperative complications

MeSH Terms

Anemia
Crohn Disease
Emergencies
Humans
Hypoalbuminemia
Incidence
Korea
Length of Stay
Male
Multivariate Analysis
Odds Ratio
Postoperative Complications
Retrospective Studies
Risk Factors
Wound Infection

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