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 29 August 2016

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News

Post-operative complications after surgery for ulcerative colitis and Crohn's disease

A study published ahead of print in the Alimentary Pharmacology & Therapeutics examines weekend hospitalizations and post-operative complications following urgent surgery for ulcerative colitis and Crohn's disease.

News image

There is increasing complexity in the management of patients with acute severe exacerbation of inflammatory bowel disease with frequent requirement for urgent surgery.

Dr Ananthakrishnan and colleagues determined whether a weekend effect exists for inflammatory bowel disease care in the United States.

The team used data from the Nationwide Inpatient Sample 2007, the largest all-payer hospitalization database in the United States.

The researchers identified discharges with a diagnosis of Crohn's disease or ulcerative colitis who underwent urgent intestinal surgery within 2 days of hospitalization using the appropriate ICD-9 codes.

The researchers examined the independent effect of admission on a weekend using multivariate logistic regression adjusting for potential confounders.

The research team evaluated 7,112 urgent intestinal surgeries in inflammatory bowel disease patients, 21% of which occurred following weekend admissions.

21% of urgent intestinal surgeries occurred following weekend admissions
Alimentary Pharmacology & Therapeutics

The team of doctors found no difference in disease severity between weekend and weekday admissions.

Post-operative complications were more common following weekend than weekday hospitalisations in ulcerative colitis.

The researchers examined that the most common post-operative complication was post-operative infections.

The most striking difference between weekend and weekday hospitalizations was noted for needing repeat laparotomy, mechanical wound complications and pulmonary complications.

In contrast, occurrence of any post-operative complication in Crohn's disease  was similar between weekday and weekend admissions.

Dr Ananthakrishnan's team commented, "Patients with ulcerative colitis hospitalized on a weekend undergoing urgent surgery within 2 days have an increased risk for post-operative complications, in particular mechanical wound complications, need for repeat laparotomy and post-operative infections."

Aliment Pharmacol Ther 2013: DOI: 10.1111/apt.12272
13 March 2013

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