Prolonged Postoperative Ileus Following Elective Colectomy: A 2014-2019 National Surgical Quality Improvement Program...

Postoperative ileus is a common complication in patients who undergo colectomies. This study provides an updated analysis of risk factors for prolonged postoperative ileus (PPOI) (≥4 days no return of bowel function) following elective colectomy, highlighting racial differences and site of colectomy. The National Surgical Quality Improvement Project dataset was queried to identify elective colectomy procedures from 2014 to 2019 (n=158 426). Univariate and multivariable logistic regression was used to identify risk factors and adverse outcomes. Twelve percent of all elective colectomies resulted in PPOI. The median age of patients with ileus was 65. The majority of patients in this sample were male (57%), ≥ 65 years (52%) and predominantly White (77%). Variables associated with PPOI include male sex, older age, smoking, right-sided colectomies, open surgery, and longer operative times. Black patients were more likely to have PPOI (AOR: 1.37, P<.001) when compared to White patients, Asian, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander patients. PPOI was also associated with longer hospital stays, more postoperative complications, and higher readmission rates. Black, male patients who undergo open, right-sided colectomies may be at greater risk for PPOI. Age ≥ 65 years, having multiple comorbidities and being a smoker were also associated with the development of PPOI. Early identification of these potential risk factors may lead to improved perioperative management to shorten return of bowel function and decrease hospital stay for patients undergoing colectomy.