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Who gets Hartmann's reversed in a regional centre?
R Hodgson1, V An2, D A Stupart2
1Department of Surgery, Barwon Health, Geelong, Australia; Department of Surgery, University of Melbourne, Austin Health, Heidelberg, Australia.
Summary
More than half of patients do not have their Hartmann's procedure stoma reversed. Advanced age was the only significant predictor for stoma reversal in this study.
Area of Science:
- Colorectal surgery
- Surgical outcomes
- Patient management
Background:
- Many patients undergoing Hartmann's procedure do not have stoma reversal.
- Predicting stoma reversal likelihood is crucial for patient care planning.
Purpose of the Study:
- To analyze parameters and comorbidity scales for predicting Hartmann's reversal.
- To identify factors influencing stoma reversal rates after Hartmann's procedure.
Main Methods:
- Retrospective analysis of 165 patients from a colorectal database (2002-2010).
- Measured parameters included age, sex, ICU admission, and comorbidity scores (ASA, POSSUM, Elixhauser).
- Statistical analysis was performed to identify predictors of reversal.
Main Results:
- Only 45% of patients (74/165) underwent stoma reversal.
- Older age, increased ICU stay, higher comorbidity scores, and malignant diagnosis were associated with decreased reversal rates.
- Age was the sole significant predictor of reversal on multivariate analysis.
Conclusions:
- Over half of patients do not have their Hartmann's stoma reversed.
- Patient age is the most significant factor predicting stoma reversal.
- Factors like comorbidities and diagnosis influence reversal decisions.
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