Related Experiment Video
Updated: Jul 6, 2025
08:20
Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice
Published on: July 12, 2018
13.1K
Care fragmentation is associated with increased mortality after ileostomy creation
Shineui Kim1, Joseph Hadaya2, Kole Joachim3
1Cardiovascular Outcomes Research Laboratories (CORELAB), University of California Los Angeles, CA. Electronic address: https://twitter.com/shineeshink.
Surgery
|December 31, 2023
Summary
Care fragmentation after ileostomy surgery significantly increases mortality risk and postoperative complications. Improving care continuity is crucial for reducing adverse outcomes and healthcare costs in these patients.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Health Services Research
Background:
- Ileostomy is a critical procedure for gastrointestinal conditions.
- Care fragmentation, where patients receive care at different facilities, poses risks for complications and readmissions.
- Understanding the impact of care fragmentation on ileostomy patients is essential.
Purpose of the Study:
- To investigate the association between care fragmentation and adverse outcomes in ileostomy patients.
- To analyze the impact of care fragmentation on hospitalization expenditures.
- To identify risks associated with fragmented care in the ileostomy population.
Main Methods:
- Utilized the Nationwide Readmissions Database (2016-2020) for adult ileostomy hospitalizations.
- Included patients readmitted within 90 days post-discharge.
- Defined care fragmentation as treatment at a different facility than the index ileostomy location and employed multivariable regressions.
Main Results:
- 17.3% of 52,254 ileostomy patients experienced care fragmentation.
- Fragmented care was linked to increased odds of mortality (aOR 1.81), cardiac (aOR 1.63), respiratory (aOR 1.71), infectious (aOR 1.33), and thromboembolic (aOR 1.28) complications.
- Care fragmentation was associated with higher hospitalization costs (+$1,700).
Conclusions:
- Care fragmentation in ileostomy patients elevates risks for mortality, complications, and healthcare costs.
- Future research should focus on inter-hospital communication to improve care continuity.
- Optimizing healthcare delivery for fragmented care populations is necessary to mitigate adverse outcomes.
Related Concept Videos
01:24Ostomy Care
304
Introduction
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:
304
01:21Inflammatory Bowel Disease V: Surgical Management
147
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
147
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
187
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
187
01:30Inflammatory Bowel Disease II: Crohn's Disease
251
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
251
01:29Appendicitis-II: Diagnostic Studies and Management
80
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
80
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
308
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
308