Factors Associated with Management Outcomes of Enterocutaneous Fistula Patients at the University of Dodoma Affiliated Teaching Hospitals

Abstract

Background: Enterocutaneous fistula (ECF) poses a significant challenge to surgeons following abdominal surgeries. This study aimed to evaluate the factors associated with management outcomes of ECF patients. Methods:This was a longitudinal analytical study conducted at 3 tertiary hospitals, from August 2022 to July 2023. A non-probability sampling technique was used, and data analysis was performed using SPSS version 26. Results:The study included 60 patients with a mean age of 40.3 ± 14.5 years, with over one-third of participants aged 45 years and above. Of all patients, 82% experienced unfavorable outcomes, with 30% succumbing to death, while 73.3% of survivors experienced an extended hospital stay due to ECF-related complications. Multivariate logistic regression analysis identified small bowel ECF (AOR: 18, 95% CI: 1.311-260.3), anemia with a hemoglobin level below 11 g/dL (AOR: 6, 95% CI: 1.115-32.42), and age above 45-years-old (AOR: 24, 95% CI: 1.268-457.5) as independent predictors of unfavorable outcomes in patients. Conclusion:Enterocutaneous fistula is not an uncommon complication among patients who have undergone abdominal surgery. Small bowel enterocutaneous fistulas, age above 45 years, and anemia with a hemoglobin level below 11 g/dl are significant factors associated with unfavorable outcomes among patients with ECF. These findings emphasize the complex nature of managing ECF and the crucial role of addressing both the primary condition and its associated complications to enhance patient outcomes.