Factors influencing outcome in patients with gastrointestinal fistula

The analysis of the prognostic factors in patients with gastrointestinal fistula requires an assessment of the quantitative and qualitative characteristics of the study population. General patient characteristics such as age, presence and degree of malnutrition, levels of plasma proteins, diagnosis of cancer or inflammatory bowel disease, or systemic sepsis must be considered, as well as local fistula characteristics. Besides the local anatomic characteristics of the fistulous tract, other factors such as fistula output, organ of origin, cause, and duration of the fistula must be considered in the assessment of a fistula patient. It is recognized, however, that it is very difficult to conclude that the presence of a single prognostic factor increases the risk in patients as complex and heterogeneous as those with digestive fistulas. It remains to be shown whether the combination of several predictive factors may enhance the chances of accurately predicting fistula closure and mortality in digestive fistulas.