| Colectomy in Intensive Care Patients: Operative Findings and Outcomes. | |
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MedLine Citation:
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PMID: 23142989 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: With a critical illness, intestinal complications are associated with high morbidity and mortality. METHODS: Operative findings and outcomes of 77 intensive care unit (ICU) patients treated with colectomy are described. RESULTS: Three conditions led to colectomy: sepsis (S group; n = 31), fulminant Clostridium difficile colitis (Cl group; n = 25), and cardiovascular surgery (CV group; n = 21). The median Acute Physiology and Chronic Health score was >25 in all groups. Thickening and distension of the colon was more frequent in the Cl group (p = 0.001), and ischemia was more frequent in the S and CV groups (p < 0.001). Widespread necrosis was more frequent in the CV patients (p = 0.001). The kappa value for ischemic operative findings and histologic necrosis was 0.64 (95 % confidence interval 0.49-0.79). Hospital mortality was 35 % without multiple organ failure (MOF) (n = 31) and 74 % with MOF (n = 46) (p < 0.001). Overall, 38 % were alive at the 1-year follow-up. CONCLUSIONS: Although colectomy in ICU patients is associated with high hospital mortality, patients who survive beyond their hospital stay have a good 1-year outcome. |
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Authors:
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Seija Sipola; Hannu Syrjälä; Vesa Koivukangas; Jouko J Laurila; Tuomo Karttunen; Pasi Ohtonen; Juha Saarnio; Tero I Ala-Kokko |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-11-10 |
Journal Detail:
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Title: World journal of surgery Volume: - ISSN: 1432-2323 ISO Abbreviation: World J Surg Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704052 Medline TA: World J Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Anaesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, P.O. Box 21, 90029, Oulu, Finland, seija.sipola@ppshp.fi. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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