The Influence of Nutritional Assessment on the Outcome of Ostomy Takedown
김민상, 김호건, 김동의, 주재균,
소속 상세정보
김민상 ( Kim Min-Sang )
Chonnam National University Hospital Department of Surgery
김호건 ( Kim Ho-Kun )
Chonnam National University Hospital Department of Surgery
김동의 ( Kim Dong-Yi )
Chonnam National University Hospital Department of Surgery
주재균 ( Ju Jae-Kyun )
Chonnam National University Hospital Department of Surgery
KMID : 0356720120280030145
Abstract
Purpose: Ostomy takedown is often considered a simple procedure without intention; however, it is associated with significant morbidity. This study is designed to evaluate factors predicting postoperative complications in the ostomy takedown in view of metabolism and nutrition.
Methods: A retrospective, institutional review-board-approved study was performed to identify all patients undergoing takedown of an ostomy from 2004 to 2010.
Results: Of all patients (150), 48 patients (32%; male, 31; female, 17) had complications. Takedown of an end-type ostomy showed a high complication rate; complications occurred in 55.9% of end-type ostomies and 15.7% of loop ostomies (P < 0.001). Severe adhesion was also related to a high rate of overall complication (41.3%) (P = 0.024). In preoperative work-up, ostomy type was not significantly associated with malnutrition status. However, postoperatively severe malnutrition level (albumin <2.8 mg/dL) was statistically significant in increasing the risk of complications (72.7%, P = 0.015). In particular, a significant postoperative decrease in albumin (>1.3 mg/dL) was associated with postoperative complications, particularly surgical site infection (SSI). Marked weight loss such as body mass index downgrading may be associated with the development of complications.
Conclusion: A temporary ostomy may not essentially result in severe malnutrition. However, a postoperative significant decrease in the albumin concentration is an independent risk factor for the development of SSI and complications.
키워드
Ostomy takedown; Malnutrition; Albumins; Surgical site infection; Complication
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