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Risk Factors for Adverse Outcomes after Ostomy Reversal in Infants Less than Six Months Old

Jeremy D Kauffman, Paul D Danielson, Nicole M Chandler

    The American Surgeon
    |November 29, 2019
    PubMed

    Insights

    Infants undergoing ostomy reversal face risks like surgical site infections and bleeding. Dependence on nutritional support and hematologic disorders are key risk factors for complications in this pediatric population.

    Area of Science:

    • Pediatric Surgery
    • Surgical Outcomes Research

    Background:

    • Ostomy reversal is a common procedure in infants.
    • Identifying risk factors for adverse outcomes is crucial for improving patient care.

    Purpose of the Study:

    • To determine risk factors for 30-day complications, reoperation, and readmission after ostomy reversal in infants under six months old.

    Main Methods:

    • Analysis of the 2012-2016 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Pediatric database.
    • Inclusion of infants aged two weeks to six months who underwent ostomy reversal.
    • Multivariable logistic regression to identify independent risk factors for 30-day outcomes.

    Main Results:

    • 16% of 1021 infants experienced 30-day complications, most commonly surgical site infections (5.7%), unplanned reintubation (5.2%), and bleeding (3%).
    • Mortality rate was 0.4%.
    • Dependence on nutritional support and hematologic disorders were independently associated with postoperative complications. Reoperation occurred in 4.4% and readmission in 2.2%.

    Conclusions:

    • Surgical site infections, unplanned reintubation, and bleeding are the most frequent complications following infant ostomy takedown.
    • Preoperative dependence on nutritional support and the presence of hematologic disorders are significant risk factors for complications.
    • Addressing these risk factors may enhance surgical outcomes for infants undergoing ostomy reversal.

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