UNEXPECTED FINDINGS DURING LAPAROTOMY SURGERY AND URGENT SURGICAL INDICATIONS ARE ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S DISEASE
ABSTRACT BACKGROUND: Patients undergoing Crohn’s disease (CD) surgery may develop a higher rate of postoperative complications (POC) than other patients. AIMS: The aim of this study was to investigate factors determining POC in patients with CD undergoing urgent laparotomy. METHODS: This is a ret...
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Colégio Brasileiro de Cirurgia Digestiva
2025-02-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202024000100345&lng=en&tlng=en |
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| author | Guilherme Zupo TEIXEIRA Magaly Gemio TEIXEIRA Marina Carla GIMENEZ Silvia Caroline Neves RIBEIRO Nathacia Bernardo CHIMELLO Vania Aparecida LEANDRO-MERHI |
| author_facet | Guilherme Zupo TEIXEIRA Magaly Gemio TEIXEIRA Marina Carla GIMENEZ Silvia Caroline Neves RIBEIRO Nathacia Bernardo CHIMELLO Vania Aparecida LEANDRO-MERHI |
| author_sort | Guilherme Zupo TEIXEIRA |
| collection | DOAJ |
| description | ABSTRACT BACKGROUND: Patients undergoing Crohn’s disease (CD) surgery may develop a higher rate of postoperative complications (POC) than other patients. AIMS: The aim of this study was to investigate factors determining POC in patients with CD undergoing urgent laparotomy. METHODS: This is a retrospective cohort study conducted on adult patients undergoing urgent laparotomy for CD. Clinical and surgical variables, medication history, American Society of Anesthesiologists classification, and POC were investigated. Data collection and management were carried out using the REDCap software (REDCap electronic data capture tools) hosted at the hospital institution. For statistical analysis, the χ2 (or Fisher’s exact) test, Student’s t-test, Mann-Whitney test, and simple and multiple multilevel logistic regression analyses were used. RESULTS: There was an association regarding the history of adalimumab use (p=0.04, OR 2.8, 95%CI 1.03-7.65), previous use of prednisone (p<0.01, OR 2.03, 95%CI 2.00-2.05), urgent surgery indications (p<0.01, OR=4.32, 95% CI=1.58-11.82), mechanical anastomosis (p=0.02, OR=0.22, 95%CI 0.06-0.80), unexpected intraoperative findings (p=0.02, OR 10.46, 95%CI 1.50-72.99), length of hospital stay greater than 10 days (p<0.01, OR 16.86, 95%CI 2.99-94.96), unplanned intensive care unit (ICU) admission (p=0.01, OR 15.06, 95%CI 1.96-115.70), and planned ICU admission (p<0.01, OR 18.46, 95%CI 3.60-94.51). On multivariate analysis, there was an association between the indication of urgent surgery (or emergency) (p=0.01, OR 4.38, 95%CI 1.43-13.37) and unexpected intraoperative findings (p=0.03, OR 8.11, 95%CI 1.21-54.50). CONCLUSIONS: Unexpected changes and urgent surgical indications are considered risk factors for POC in patients with CD. |
| format | Article |
| id | doaj-art-129d946101c443ecbb408038eb212945 |
| institution | Kabale University |
| issn | 0102-6720 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj-art-129d946101c443ecbb408038eb2129452025-02-04T07:41:40ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202025-02-013710.1590/0102-6720202400073e1867UNEXPECTED FINDINGS DURING LAPAROTOMY SURGERY AND URGENT SURGICAL INDICATIONS ARE ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S DISEASEGuilherme Zupo TEIXEIRAhttps://orcid.org/0009-0004-7141-8751Magaly Gemio TEIXEIRAhttps://orcid.org/0009-0001-3378-744XMarina Carla GIMENEZhttps://orcid.org/0009-0004-6444-0651Silvia Caroline Neves RIBEIROhttps://orcid.org/0000-0001-6493-7757Nathacia Bernardo CHIMELLOhttps://orcid.org/0009-0002-2588-3965Vania Aparecida LEANDRO-MERHIhttps://orcid.org/0000-0002-2623-6471ABSTRACT BACKGROUND: Patients undergoing Crohn’s disease (CD) surgery may develop a higher rate of postoperative complications (POC) than other patients. AIMS: The aim of this study was to investigate factors determining POC in patients with CD undergoing urgent laparotomy. METHODS: This is a retrospective cohort study conducted on adult patients undergoing urgent laparotomy for CD. Clinical and surgical variables, medication history, American Society of Anesthesiologists classification, and POC were investigated. Data collection and management were carried out using the REDCap software (REDCap electronic data capture tools) hosted at the hospital institution. For statistical analysis, the χ2 (or Fisher’s exact) test, Student’s t-test, Mann-Whitney test, and simple and multiple multilevel logistic regression analyses were used. RESULTS: There was an association regarding the history of adalimumab use (p=0.04, OR 2.8, 95%CI 1.03-7.65), previous use of prednisone (p<0.01, OR 2.03, 95%CI 2.00-2.05), urgent surgery indications (p<0.01, OR=4.32, 95% CI=1.58-11.82), mechanical anastomosis (p=0.02, OR=0.22, 95%CI 0.06-0.80), unexpected intraoperative findings (p=0.02, OR 10.46, 95%CI 1.50-72.99), length of hospital stay greater than 10 days (p<0.01, OR 16.86, 95%CI 2.99-94.96), unplanned intensive care unit (ICU) admission (p=0.01, OR 15.06, 95%CI 1.96-115.70), and planned ICU admission (p<0.01, OR 18.46, 95%CI 3.60-94.51). On multivariate analysis, there was an association between the indication of urgent surgery (or emergency) (p=0.01, OR 4.38, 95%CI 1.43-13.37) and unexpected intraoperative findings (p=0.03, OR 8.11, 95%CI 1.21-54.50). CONCLUSIONS: Unexpected changes and urgent surgical indications are considered risk factors for POC in patients with CD.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202024000100345&lng=en&tlng=enCrohn’s DiseaseLaparotomyPostoperative ComplicationsRisk Factors. |
| spellingShingle | Guilherme Zupo TEIXEIRA Magaly Gemio TEIXEIRA Marina Carla GIMENEZ Silvia Caroline Neves RIBEIRO Nathacia Bernardo CHIMELLO Vania Aparecida LEANDRO-MERHI UNEXPECTED FINDINGS DURING LAPAROTOMY SURGERY AND URGENT SURGICAL INDICATIONS ARE ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S DISEASE ABCD: Arquivos Brasileiros de Cirurgia Digestiva Crohn’s Disease Laparotomy Postoperative Complications Risk Factors. |
| title | UNEXPECTED FINDINGS DURING LAPAROTOMY SURGERY AND URGENT SURGICAL INDICATIONS ARE ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S DISEASE |
| title_full | UNEXPECTED FINDINGS DURING LAPAROTOMY SURGERY AND URGENT SURGICAL INDICATIONS ARE ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S DISEASE |
| title_fullStr | UNEXPECTED FINDINGS DURING LAPAROTOMY SURGERY AND URGENT SURGICAL INDICATIONS ARE ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S DISEASE |
| title_full_unstemmed | UNEXPECTED FINDINGS DURING LAPAROTOMY SURGERY AND URGENT SURGICAL INDICATIONS ARE ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S DISEASE |
| title_short | UNEXPECTED FINDINGS DURING LAPAROTOMY SURGERY AND URGENT SURGICAL INDICATIONS ARE ASSOCIATED WITH POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S DISEASE |
| title_sort | unexpected findings during laparotomy surgery and urgent surgical indications are associated with postoperative complications in patients with crohn s disease |
| topic | Crohn’s Disease Laparotomy Postoperative Complications Risk Factors. |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202024000100345&lng=en&tlng=en |
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