Epidemiology and outcome of patients with postoperative abdominal fistula
Janaina Wercka1, Patricia Paola Cagol2, André Luiz Parizi Melo1
1Hospital Regional de São José Homero de Miranda Gomes, São Jose, SC, Brasil, Hospital Regional de São José Homero de Miranda Gomes, São Jose SC , Brasil.
Objective:
to present the epidemiological profile, incidence and outcome of patients who developing postoperative abdominal fistula.
Methods:
This observational, cross-sectional, prospective study evaluated patients undergoing abdominal surgery. We studied the epidemiological profile, the incidence of postoperative fistulas and their characteristics, the outcome of this complication and the predictors of mortality.
Results:
The sample consisted of 1,148 patients. The incidence of fistula was 5.5%. There was predominance of biliary fistula (26%), followed by colonic fistulas (22%) and stomach (15%). The average time to onset of fistula was 6.3 days. For closure, the average was 25.6 days. The mortality rate of patients with fistula was 25.4%. Predictors of mortality in patients who developed fistula were age over 60 years, presence of comorbidities, fistula closure time more than 19 days, no spontaneous closure of the fistula, malnutrition, sepsis and need for admission to the Intensive Care Unit.
Conclusion:
abdominal postoperative fistulas are still relatively frequent and associated with significant morbidity and mortality.
Objetivo:
apresentar o perfil epidemiológico, incidência e desfecho em pacientes que evoluíram com fístula abdominal pós-operatória.
MéTodos:
trata-se de um estudo prospectivo transversal observacional que avaliou pacientes submetidos à cirurgia abdominal. Foram estudados o perfil epidemiológico, a incidência das fístulas pós-operatórias e suas características, desfecho desta complicaçãoe fatores preditivos de mortalidade.
Resultados:
a amostra constou de 1148 pacientes. A incidência de fístula foi 5,5%. Houve predominância de fístulas biliares (26%), seguidas de fístulas colônicas (22%) e gástricas (15%). O tempo médio para o surgimento da fístula foi 6,3 dias. Para o fechamento, a média foi 25,6 dias. A taxa de mortalidade dos pacientes com fístula foi 25,4%. Os fatores preditivos de mortalidade nos casos que desenvolveram fístula foram idade maior do que 60 anos, presença de comorbidades, tempo de fechamento da fístula superior a 19 dias, não fechamento espontâneo da fístula, desnutrição, sepse e necessidade de admissão em Unidade de Terapia Intensiva.
ConclusãO:
as fístulas pós-operatórias abdominais ainda são relativamente frequentes e associadas à morbidade e mortalidade significativas.
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