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Session: ePoster Monitor 1-Benign Abdominal Disease 1

eP112 - Predictors of Mortality and Major Complications After Colostomy Reversal: An Analysis of National Surgical Quality Improvement Program Database 2012-2021

Sunday, June 2, 2024
9:06 AM – 9:11 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Mitchell McCain, MD

    General Surgery Resident
    University of Oklahoma- Tulsa
    University of Oklahoma - Tulsa
    Tulsa, OK, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • MN

    Manh Nguyen, n/a

    Medical Student
    OU-TU School of Community Medicine
    Oklahoma City, Oklahoma, United States

    Disclosure information not submitted.

  • NH

    Nicholas Hollman, MPH

    Research Biostatistician
    Office of Research Development and Scholarly Activity, University of Oklahoma School of Community Medicine, Tulsa, OK 74135, USA
    Tulsa, Oklahoma, United States

    Disclosure information not submitted.

  • SH

    Stuart D. Hoff, F.A.S.C.R.S.

    Assistant Professor of Surgery
    University of Oklahoma
    Tulsa, Oklahoma, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • ZK

    Zhamak Khorgami, MD

    Assistant Professor of Surgery
    University of Oklahoma - Tulsa
    Tulsa, Oklahoma, United States

    Disclosure information not submitted.

Purpose/Background: Colostomy reversal has been shown to be associated with significant risk of post-operative morbidity and mortality. We aimed to better determine the predictors of post-operative complications to facilitate surgical decision making and informed consent for patients potentially undergoing colostomy reversal.Methods/Interventions: From the ACS National Surgical Quality Improvement Program (NSQIP) database, we identified patients undergoing elective open or laparoscopic colostomy reversal based on procedure and diagnosis codes. A multivariable analysis using data from 2012-2021 was performed to determine independent risk factors of 30-day major complications (any complication except urinary tract infection and superficial wound infection) and death following a colostomy reversal.Results/Outcomes: A total of 19,542 patients were analyzed. Independent predictors of death were being 70 years old or older, history of severe chronic obstructive pulmonary disease (COPD), having a dependent or partially dependent functional status, steroid use for a chronic condition, and being currently on dialysis (Table 1). Independent predictors of a major complication following surgery were being 70 years old or older, having a BMI≥40 kg/m2, being a smoker in 12 months prior to surgery, history of severe COPD, having a dependent or partially dependent functional status, hypertension requiring medication, steroid use for a chronic condition, being on dialysis, and having a bleeding disorder (Table 2). When compared with laparoscopic reversal, the open approach was an independent predictor of both major complications and death (Tables 1&2).Conclusion/

Discussion: Colostomy reversal can be associated with a higher risk of complication and death in patients with older age, morbid obesity, dependent functional status, recent smoking, steroid use, and certain comorbidities including COPD, current dialysis, hypertension, and bleeding disorder. Identifying higher-risk patients can help in preoperative counseling before colostomy reversal. Prehabilitation and optimization of modifiable factors, as well as considering a laparoscopic approach, may decrease postoperative mortality and morbidity in this group of patients.Summarized multivariable model results for 30-day death and major complication