Postoperative morbidity and mortality following a colectomy for ulcerative colitis has been primarily reported from tertiary care referral centers that perform a high volume of operations.
However, the postoperative outcomes among nonselected hospitals are not known.
|Postoperative mortality was 2%|
Dr Gilaad Kaplan and colleagues from Canada evaluated postoperative morbidity and mortality using a nationally representative database.
The researchers also determined the factors that influenced outcomes.
The team analyzed the 1995 to 2005 Nationwide Inpatient Sample to identify 7,108 discharges for ulcerative colitis patients who underwent a total abdominal colectomy.
The effects of hospital volume on postoperative morbidity and mortality were evaluated in logistic regression models adjusting for demographic and clinical factors.
The researchers found that postoperative mortality and morbidity rates were 2% and 31%, respectively.
The team performed most operations in low-volume hospitals that had an increased risk of death.
The team found in-hospital mortality was increased in patients who were admitted emergently, aged 60 to 80 years, and those with Medicaid.
Emergency-admitted ulcerative colitis patients, whose surgery was performed 6 days after their admission, had significantly increased likelihood of in-hospital death.
Dr Kaplan's team concluded, "Postoperative mortality was lowest in hospitals that performed the highest volume of operations."
"Increasing the proportion of total colectomies performed in high-volume hospitals may improve clinical outcomes for patients with ulcerative colitis."