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Abdominal Surgical Procedures in Adult Patients With Cystic Fibrosis: What Are the Risks?
Melissa A Hite1, Wolfgang B Gaertner1, Bryan Garcia2
1Division of Colon and Rectal Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina.
Diseases of the Colon and Rectum
|January 14, 2022
Summary
Surgical admissions for adult cystic fibrosis patients are rising, with most procedures being nonelective. Major gastrointestinal surgeries in this population are linked to substantial morbidity, mortality, and extended hospital stays.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Adult Cystic Fibrosis Care
Background:
- Adult cystic fibrosis (CF) patients are living longer due to medical advancements.
- Limited data exist on the gastrointestinal (GI) surgical needs and outcomes in this growing adult CF population.
Purpose of the Study:
- To analyze trends in abdominal GI surgery among adult CF patients.
- To evaluate postoperative outcomes, including morbidity and mortality, associated with GI surgery in adults with CF.
Main Methods:
- A national retrospective cohort study utilizing a national all-payor administrative database from 2000 to 2014.
- Inclusion criteria: adult patients (≥18 years) with cystic fibrosis undergoing abdominal GI surgery.
- Outcomes assessed: trends in surgical admissions, morbidity, and mortality by procedure type.
Main Results:
- 3,075 abdominal surgery admissions were identified; 28% were elective.
- Major GI surgical procedures increased significantly over the study period (p < 0.01).
- For major GI surgery: in-hospital mortality was 6%, morbidity was 37%, and mean length of stay was 15.9 days.
Conclusions:
- Abdominal GI surgery admissions are increasing in adult CF patients, predominantly non-elective.
- Major GI surgery in this cohort is associated with significant morbidity, mortality, and prolonged hospitalization.
- Findings highlight the need to consider perioperative risk for adult CF patients requiring GI surgery.
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