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Published in:

01-02-2013

Colectomy in Intensive Care Patients: Operative Findings and Outcomes

Authors: Seija Sipola, Hannu Syrjälä, Vesa Koivukangas, Jouko J. Laurila, Tuomo Karttunen, Pasi Ohtonen, Juha Saarnio, Tero I. Ala-Kokko

Published in: World Journal of Surgery | Issue 2/2013

Abstract

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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Title: Colectomy in Intensive Care Patients: Operative Findings and Outcomes
Authors: Seija Sipola
Hannu Syrjälä
Vesa Koivukangas
Jouko J. Laurila
Tuomo Karttunen
Pasi Ohtonen
Juha Saarnio
Tero I. Ala-Kokko
Publication date: 01-02-2013
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 2/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1836-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Colectomy in Intensive Care Patients: Operative Findings and Outcomes

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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