Factors predictive of high-output ileostomy: a retrospective single-center comparative study

High-output syndrome (HOS) is a complication of ileostomy, which can affect quality of life significantly; however, its exact cause remains unknown. The aim of this study was to establish the frequency, as well as the preoperative and intraoperative factors predictive of HOS.

The subjects of this study were 164 consecutive patients who underwent colorectal cancer surgery with ileostomy construction at our institute between January, 2011 and August, 2018. Thirteen patients with postoperative complications reported as causes of HOS, including intraperitoneal abscess, paralytic ileus, and outlet obstruction, were excluded. We used a logistic regression analysis to identify the factors predictive of HOS.

HOS developed in 36 of the 151 patients (23.8%). There were significantly more diabetic patients in the HOS group (P = 0.03), but other patient factors such as age, gender, body mass index, and use of daily laxatives were not significantly different between the groups. The HOS group had significantly more cases of total proctocolectomy (P = 0.04), but other surgical factors such as operative time, and blood transfusion were not significantly different between the two groups.

These results indicate that diabetes and total proctocolectomy are preoperative predictors of HOS, allowing for the possibility of early intervention via post-surgical treatment.