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Incidence rates and predictors of stomal-related complications: a 1-year prospective study
Mei-Yu Hsu1, Hsiao-Hui Hsu1, Yu-Lin Wu1
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Insights
Stomal-related complications affect nearly half of ostomy patients. Emergency surgery, laparoscopic procedures, and incorrect stoma placement significantly increase the risk of these complications.
Area of Science:
- Colorectal surgery
- Ostomy care
- Surgical complications
Background:
- Stomal-related complications (SRCs) represent a significant burden on healthcare systems.
- These complications negatively impact patients' quality of life.
Purpose of the Study:
- To determine the incidence rates of stomal complications (SCs) and peristomal complications (PCs).
- To identify predictors associated with the development of SCs and PCs.
Main Methods:
- A prospective cohort study involving 215 ostomy patients followed for 360 days.
- Stomal-related complications were assessed by a colorectal surgeon and WOC nurses at multiple time points.
- Complications were categorized into stomal complications (SCs) and peristomal complications (PCs).
Main Results:
- SRCs were observed in 48.8% of patients, with 145 total complications recorded.
- Emergency surgery (OR: 2.78), laparoscopic surgery (OR: 2.91), and inappropriate stomal location (OR: 19.23) were significant predictors of SCs.
- Inappropriate stomal location was also a significant predictor for PCs (OR: 7.70).
Conclusions:
- Emergency or laparoscopic surgery and inappropriate stomal sites increase the risk of stomal complications.
- Inappropriate stomal site is a key predictor for both stomal and peristomal complications.
Background:
Stomal-related complications (SRCs) increase the health care burden and impair quality of life.
Purpose:
To determine the incidence rates and predictors of stomal and peristomal complications (SCs and PCs, respectively).
Methods:
This was a prospective cohort study. In total, 215 patients who had undergone ostomy were enrolled and followed-up at 3, 30, 90, 180, and 360 days after surgery. During the follow-up period, SRCs were assessed by 1 colorectal surgeon and 2 wound, ostomy, and continence nurses. The SRCs were classified into SCs and PCs.
Results:
SRCs were observed in 105 patients (48.8%). The 105 patients had 145 SRCs (66 [45.5%] SCs and 79 [54.5%] PCs). A logistic regression analysis revealed that emergency surgery (odds ratio [OR]: 2.78; P = .041), laparoscopic surgery (OR: 2.91; P = .023), and inappropriate stomal location (OR: 19.23; P < .001) were significant predictors of SCs. Inappropriate stomal location also was significantly associated with PCs (OR: 7.70; P < .001). The cumulative incidence rate of SRCs was 73% in patients who underwent stomal surgery and were followed for 360 days.
Conclusions:
Stomas created through emergency or laparoscopic surgery and those created at inappropriate sites were associated with a higher risk of SCs. Inappropriate stomal site was found to be a significant predictor for SCs and PCs.
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