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Significant risk factors in elective colorectal surgery

R D Kingston1, S Walsh, C Robinson

  • 1Department of Clinical Studies, Trafford General Hospital, Manchester.

Annals of the Royal College of Surgeons of England
|September 1, 1995
PubMed
Summary

This study identified risk factors for complications in elective colorectal surgery. Patient

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Area of Science:

  • Colorectal Surgery
  • Surgical Outcomes
  • Infection Control

Background:

  • Elective colorectal surgery carries inherent risks.
  • Identifying preoperative risk factors is crucial for patient management.
  • Previous studies have explored various risk determinants.

Purpose of the Study:

  • To identify risk factors associated with wound infection and operative mortality in elective colorectal surgery.
  • To analyze the influence of patient demographics, surgical factors, and preoperative status on surgical outcomes.

Main Methods:

  • Prospective study of 618 patients undergoing elective colorectal surgery over 10 years.
  • Multivariate analysis employed to identify significant risk factors.
  • Data collected on patient characteristics, surgical procedures, and postoperative complications.

Main Results:

  • Wound infection risk increased with septicaemia, respiratory sepsis, faecal contamination, consultant surgeon, and pelvic procedures.
  • Serious complications were linked to male gender and poor physical status.
  • Operative mortality associated with poor physical status, respiratory sepsis, and intra-abdominal abscess.
  • Preoperative risk factors identified: patient gender, physical status, and surgeon seniority.

Conclusions:

  • Patient gender, physical status, and surgeon seniority are key preoperative risk factors.
  • Pelvic procedures and consultant involvement, particularly with high-risk patients, warrant careful consideration.
  • Multivariate analysis confirms specific clinical and surgical factors influencing outcomes in colorectal surgery.

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