Sepsis is a major predictor of failure after ileal pouch-anal anastomosis

Diseases of the Colon and Rectum
Shawn S ForbesRobin S McLeod

Abstract

This study aimed to determine the risk of ileal pouch-anal anastomosis failure and factors predictive of failure overall and in patients with septic complications. Patients were identified through a prospectively maintained patient registry. All patients registered in the Mount Sinai Hospital Inflammatory Bowel Disease database who had an ileal pouch-anal anastomosis for more than 12 months were included in the study. Pouch failure was defined as ileal pouch-anal anastomosis excision or permanent diversion. Cox proportional hazard models with death as a competing risk were created, modeling time to failure as the outcome of interest for all patients and for the subgroup of patients with septic complications. The study included 1,554 patients. One hundred six patients experienced an ileal pouch-anal anastomosis failure (6.8%), 49 (46.2%) of these failures were caused by septic complications. Independent predictors of failure included Crohn's disease (hazard ratio 7.5, 95% confidence interval [4.7, 12.0]) and postoperative sepsis (hazard ratio 6.6, 95% confidence interval [4.4, 9.8]). In the subgroup of patients with failure due to postoperative septic complications, independent predictors of failure were Crohn's disease (hazard ...Continue Reading

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Citations

Jun 11, 2014·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jhananiee SubendranAnand Govindarajan
Nov 28, 2012·The Surgical Clinics of North America·Todd D Francone, Brad Champagne
Feb 5, 2011·Journal of Pediatric Surgery·Karthik MaruthachalamBruce Jaffray
Dec 24, 2013·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Xian-rui WuBo Shen
Jun 25, 2015·International Journal of Colorectal Disease·Siham ZerhouniZane Cohen
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Dec 2, 2014·Inflammatory Bowel Diseases·Haluk T Kani, Bo Shen
May 17, 2018·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·G H T WorleyO D Faiz
Dec 28, 2019·Inflammatory Bowel Diseases·Adam S FayeChin Hur
Mar 9, 2011·Diseases of the Colon and Rectum·Pasha J NisarVictor W Fazio
Oct 1, 2016·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·V A van der PloegS K Clark
Jan 15, 2015·Diseases of the Colon and Rectum·Xian-Rui WuJames M Church
Apr 20, 2012·Diseases of the Colon and Rectum·Usama Ahmed AliRavi P Kiran
Mar 20, 2012·Diseases of the Colon and Rectum·James M KielyRavi P Kiran
Dec 14, 2011·Diseases of the Colon and Rectum·Ravi P KiranVictor W Fazio
Jan 31, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Essi K KarjalainenAnna H Lepistö
Nov 6, 2020·Diseases of the Colon and Rectum·Amandeep PooniMantaj S Brar

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