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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.

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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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