RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPY
ABSTRACT BACKGROUND: Despite major advances in the clinical treatment of inflammatory bowel disease, some patients still present with acute colitis and require emergency surgery. AIMS: To evaluate the risk factors for early postoperative complications in patients undergoing surgery for acute colit...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2023-10-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202023000100338&lng=en&tlng=en |
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| author | Lucas Faraco Sobrado Fernando Noboru Cabral Mori Carolina Bortolozzo Graciolli Facanali Mariane Gouvea Monteiro Camargo Sérgio Carlos Nahas Carlos Walter Sobrado |
| author_facet | Lucas Faraco Sobrado Fernando Noboru Cabral Mori Carolina Bortolozzo Graciolli Facanali Mariane Gouvea Monteiro Camargo Sérgio Carlos Nahas Carlos Walter Sobrado |
| author_sort | Lucas Faraco Sobrado |
| collection | DOAJ |
| description | ABSTRACT BACKGROUND: Despite major advances in the clinical treatment of inflammatory bowel disease, some patients still present with acute colitis and require emergency surgery. AIMS: To evaluate the risk factors for early postoperative complications in patients undergoing surgery for acute colitis in the era of biologic therapy. METHODS: Patients with inflammatory bowel disease admitted for acute colitis who underwent total colectomy at a single tertiary hospital from 2012 to 2022 were evaluated. Postoperative complications were graded according to Clavien-Dindo classification (CDC). Patients with more severe complications (CDC≥2) were compared with those with less severe complications (CDC<2). RESULTS: A total of 46 patients underwent surgery. The indications were: failure of clinical treatment (n=34), patients’ or surgeon's preference (n=5), hemorrhage (n=3), toxic megacolon (n=2), and bowel perforation (n=2). There were eight reoperations, 60.9% of postoperative complications classified as CDC≥2, and three deaths. In univariate analyses, preoperative antibiotics use, ulcerative colitis diagnosis, lower albumin levels at admission, and preoperative hospital stay longer than seven days were associated with more severe postoperative complications. CONCLUSIONS: Emergency surgery for acute colitis was associated with a high incidence of postoperative complications. Preoperative use of antibiotics, ulcerative colitis, lower albumin levels at admission, and delaying surgery for more than seven days were associated with more severe early postoperative complications. The use of biologics was not associated with worse outcomes. |
| first_indexed | 2024-03-11T16:29:04Z |
| format | Article |
| id | doaj.art-50b38c9c6d354a59b997ecd0e256c0e9 |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-03-11T16:29:04Z |
| publishDate | 2023-10-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-50b38c9c6d354a59b997ecd0e256c0e92023-10-24T07:48:57ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202023-10-013610.1590/0102-672020230052e1770RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPYLucas Faraco Sobradohttps://orcid.org/0000-0002-2336-5278Fernando Noboru Cabral Morihttps://orcid.org/0000-0002-8924-6298Carolina Bortolozzo Graciolli Facanalihttps://orcid.org/0000-0002-1656-7736Mariane Gouvea Monteiro Camargohttps://orcid.org/0000-0002-5906-1663Sérgio Carlos Nahashttps://orcid.org/0000-0002-2268-4146Carlos Walter Sobradohttps://orcid.org/0000-0003-2813-4193ABSTRACT BACKGROUND: Despite major advances in the clinical treatment of inflammatory bowel disease, some patients still present with acute colitis and require emergency surgery. AIMS: To evaluate the risk factors for early postoperative complications in patients undergoing surgery for acute colitis in the era of biologic therapy. METHODS: Patients with inflammatory bowel disease admitted for acute colitis who underwent total colectomy at a single tertiary hospital from 2012 to 2022 were evaluated. Postoperative complications were graded according to Clavien-Dindo classification (CDC). Patients with more severe complications (CDC≥2) were compared with those with less severe complications (CDC<2). RESULTS: A total of 46 patients underwent surgery. The indications were: failure of clinical treatment (n=34), patients’ or surgeon's preference (n=5), hemorrhage (n=3), toxic megacolon (n=2), and bowel perforation (n=2). There were eight reoperations, 60.9% of postoperative complications classified as CDC≥2, and three deaths. In univariate analyses, preoperative antibiotics use, ulcerative colitis diagnosis, lower albumin levels at admission, and preoperative hospital stay longer than seven days were associated with more severe postoperative complications. CONCLUSIONS: Emergency surgery for acute colitis was associated with a high incidence of postoperative complications. Preoperative use of antibiotics, ulcerative colitis, lower albumin levels at admission, and delaying surgery for more than seven days were associated with more severe early postoperative complications. The use of biologics was not associated with worse outcomes.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202023000100338&lng=en&tlng=enProctocolitisPostoperative complicationsColitisColectomyRisk factorsBiological therapy |
| spellingShingle | Lucas Faraco Sobrado Fernando Noboru Cabral Mori Carolina Bortolozzo Graciolli Facanali Mariane Gouvea Monteiro Camargo Sérgio Carlos Nahas Carlos Walter Sobrado RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPY ABCD: Arquivos Brasileiros de Cirurgia Digestiva Proctocolitis Postoperative complications Colitis Colectomy Risk factors Biological therapy |
| title | RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPY |
| title_full | RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPY |
| title_fullStr | RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPY |
| title_full_unstemmed | RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPY |
| title_short | RISK FACTORS FOR EARLY POSTOPERATIVE COMPLICATIONS IN ACUTE COLITIS IN THE ERA OF BIOLOGIC THERAPY |
| title_sort | risk factors for early postoperative complications in acute colitis in the era of biologic therapy |
| topic | Proctocolitis Postoperative complications Colitis Colectomy Risk factors Biological therapy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202023000100338&lng=en&tlng=en |
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