Most studies of enterocutaneous fistula report management and outcome.
Few studies examine factors predicting healing and mortality.
Dr Mawdsley and colleagues from the United Kingdom identified factors predicting healing and mortality in patients with enterocutaneous fistula managed either with a definitive attempt at surgical closure or conservatively.
The team reviewed the case notes of 277 patients with enterocutaneous fistula, treated over a 10 year period.
|11 factors were examined for their relationship to fistula healing|
|Alimentary Pharmacology & Therapeutics|
Patients were divided into those managed operatively or conservatively.
The research team examined 11 factors for their relationship to fistula healing and fistula-related mortality.
For patients treated operatively, successful enterocutaneous fistula closure related only to the complexity of the fistula.
However, fistula-related mortality was related only to the presence of comorbidity.
In patients managed conservatively, a decreased likelihood of enterocutaneous fistula closure was associated with a high fistula output, comorbidity and being referred from an external institution.
Fistula related-mortality in this group was related to a high output, and an increased age.
Dr Mawdsley’s team concluded, “In patients managed operatively, fistula healing and fistula-related mortality are each associated with only 1 factor.”
“However, in patients managed conservatively healing and mortality are predicted by 3 and 2 factors, respectively.”