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Colectomy in Intensive Care Patients: Operative Findings and Outcomes.
MedLine Citation:
PMID:  23142989     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  JOURNAL ARTICLE     Date:  2012-11-10
Journal Detail:
Title:  World journal of surgery     Volume:  -     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
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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