Dehydration Is the Most Common Indication for Readmission After Diverting Ileostomy Creation

Messaris, Evangelos; Sehgal, Rishabh; Deiling, Susan; Koltun, Walter A.; Stewart, David B.; McKenna, Kevin J.; Poritz, Lisa S.

doi:10.1097/dcr.0b013e31823d0ec5

Cited by 248 publications

(220 citation statements)

References 16 publications

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“…Stoma-related complications were experienced by 42.6% of patients in the LC group and accounted for 83% of LC readmissions. Although this rate of ileostomy morbidity is comparable to rates reported in the literature, it is considerably higher than that seen in the EC group [4,5,7,8,13,29]. The healthcare costs associated with these complications are evident in this study, with the increased readmission rate being a major source of increased hospital costs in the LC group.…”

Section: Discussionsupporting

confidence: 49%

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Cost Analysis of Early versus Delayed Loop Ileostomy Closure: A Case-Matched Study

et al. 2015

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Background/Aims: The optimal timing for the closure of loop ileostomies remains controversial. The aim of the current study was to investigate whether early ileostomy closure (EC) (<2 weeks post-formation) results in significant healthcare savings as against late closure (LC). Methods: Patients with available cost data that underwent EC between January 2008 and December 2012 were compared against matched patients undergoing LC during the same period. Direct hospital costs for the two groups were compared. Results: There were 42 EC patients and 61 LC patients. EC patients had significantly less ileostomy-related complications (p < 0.001) and hospital readmissions (p < 0.001). Operative time (p < 0.001) and operative cost (p = 0.002) were also both significantly less in the EC group. Community nursing costs favoured the LC group (p = 0.047). The EC group had an increased post-closure wound infection rate (p = 0.02). The mean total direct cost per patient was NZD 13,724 (SD NZD 3,736) for EC and NZD 16,728 (SD NZD 8,028) for LC. Representing an average costs saving of NZD 3,004 per patient favouring EC (p = 0.012). Conclusion: Although EC increases the post-closure wound infection rate, EC reduces ileostomy complications, hospital readmissions and operative costs resulting in significant healthcare savings. In order to improve patient outcomes and make EC even more cost effective, efforts should be taken to reduce wound infections.

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Section: Discussionsupporting

confidence: 49%

“…However, this protective benefit is unfortunately often at the expense of significant stoma-related morbidity. Defunctioning loop ileostomies are typically reversed after a period of 8-12 weeks, during which time as many as 19-74% of ileostomy patients will experience ileostomy-related complications [4,5,6,7,8]. …”

Section: Introductionmentioning

confidence: 99%

Cost Analysis of Early versus Delayed Loop Ileostomy Closure: A Case-Matched Study

et al. 2015

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“…Obviously, AL rates are only calculated for patients in whom an anastomosis has been created. Therefore hospitals with lower rates of patients with anastomoses could automatically have better scores without providing better quality of care, as the stoma itself may cause morbidity, lead to increased readmissions51 52 and may be associated with morbidity at the time of surgical removal of the stoma 53. In reality, there is probably an optimum percentage of defunctioning stomas and end colostomies to be constructed, and AL rates should always be seen in the light of these percentages.…”

Section: Discussionmentioning

confidence: 99%

Anastomotic leakage as an outcome measure for quality of colorectal cancer surgery

et al. 2013

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“…Estas apresentam elevados índices de morbimortalidade, o que contribui para a diminuição da qualidade de vida dos pacientes estomizados (6,10) . As complicações, que podem ser classificadas em recentes ou tardias, geram hospitalizações mais longas e maiores taxas de readmissão, cursando com elevados custos hospitalares (11) . As complicações recentes abrangem, principalmente, o sítio inapropriado, escoriação em pele, retração ou necrose do estoma, desidratação e escape do conteúdo colônico, que causam ferimentos à pele.…”

Section: Introductionunclassified

Cuidado e saúde em pacientes estomizados

Oliveira

Silva

et al. 2018

RBPS

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Este artigo está publicado em acesso aberto (Open Access) sob a licença Creative Commons, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho seja corretamente citado. CUIDADO E SAÚDE EM PACIENTES ESTOMIZADOS Care and health of ostomy patients Cuidado y salud de pacientes estomizados Isabella Valadares de OliveiraPontifícia Universidade Católica de Goiás -PUC Goiás -Goiânia (GO) -Brasil Mariana Cabral SilvaPontifícia Universidade Católica de Goiás -PUC Goiás -Goiânia (GO) -Brasil Eduardo Lenza SilvaPontifícia Universidade Católica de Goiás -PUC Goiás -Goiânia (GO) -Brasil Victor Fernandes de FreitasPontifícia Universidade Católica de Goiás -PUC Goiás -Goiânia (GO) -Brasil Fernando Rezek RodriguesUniversidade Federal de Goiás -UFG -Goiânia (GO) -Brasil Luciana Morelli CaldeiraPontifícia Universidade Católica de Goiás -PUC Goiás -Goiânia (GO) -Brasil Santa Casa de Misericórdia de Goiânia -Goiânia (GO) -Brasil RESUMO Objetivo: Descrever os aspectos epidemiológicos, as complicações e as hospitalizações relacionadas à estomia. Métodos: Trata-se de um estudo transversal, descritivo e quantitativo das variáveis: sexo, idade, faixa etária, raça/cor, tempo de estomia, tipo de estomia, etiologia, complicações e internações hospitalares associadas à colostomia de 123 pacientes atendidos no ambulatório de enfermagem para pacientes estomizados de um hospital escola em Goiânia, Goiás, Brasil. Após a disposição dos dados em tabelas, utilizou-se o software Epi Info 7 para a descrição dos resultados, a análise de prevalências e a associação de variáveis. Resultados: 51,2% (n=63) dos pacientes eram do sexo masculino e houve predominância do tipo de colostomia terminal (n=68;57,6%), enquanto 24,5% (n=29) era do tipo em alça e 17% (n=20) do tipo dupla boca. Quanto à etiologia da estomia, 40,5% (n=49) ocorreu por neoplasia, 17,3% (n=21) por doença inflamatória intestinal e 9% (n=11) por trauma. O desenvolvimento de complicações esteve presente em 38 (30,89%) pacientes, sendo a dermatite periestomal a principal delas, e 9 (7%) pacientes necessitaram de internação hospitalar relacionada à estomia. Conclusão: Observa-se que os pacientes investigados apresentam predominância do sexo masculino, média de idade de 61,5 anos, raça/cor parda, de colostomia terminal e etiologia neoplásica, sendo a maioria dos pacientes portadores de colostomia há cerca de 5 anos. Descritores

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Dehydration Is the Most Common Indication for Readmission After Diverting Ileostomy Creation

Cited by 248 publications

References 16 publications

Cost Analysis of Early versus Delayed Loop Ileostomy Closure: A Case-Matched Study

Cost Analysis of Early versus Delayed Loop Ileostomy Closure: A Case-Matched Study

Anastomotic leakage as an outcome measure for quality of colorectal cancer surgery

Cuidado e saúde em pacientes estomizados

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