Postoperative readmissions following ileostomy formation among patients with a gynecologic malignancy.

Michelle A. Glasgow, Kristin Shields, Rachel Isaksson Vogel, Deanna Teoh, Peter A. Argenta

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Ileostomy results in a relatively poorer water reabsorption and is associated with dehydration and renal injury. These problems may be exacerbated in the setting of gynecologic cancers owing to both patient and disease-related factors. We evaluated the rate and reasons for hospital readmission within 30 days of ileostomy creation in patients with a gynecologic malignancy. We performed a retrospective review of women with gynecologic malignancies who underwent ileostomy creation between 2002 and 2013. Fifty-three patients were eligible for analysis. The mean age was 63.3 years. Most patients had ovarian cancer (86.5%). Indications for ileostomy included small bowel obstruction (45.3%), as part of primary debulking (18.9%), or treatment of an anastomotic leak (15.1%). The 30-day readmission rate was 34%. Co-morbid diseases such as hypertension (p=0.008) and chronic kidney disease (p=0.010) were more common among women who were readmitted. The most common reasons for readmission were dehydration (38.9%) and acute renal failure (33.3%); women readmitted for these conditions had higher average serum creatinine levels at initial postoperative discharge (1.00 mg/dL versus 0.71 mg/dL, p=0.017) than women who did not require readmission. Readmitted women had a trend toward shorter overall survival (0.41 years versus 1.67 years, p=0.061). Readmission rates for gynecologic oncology patients undergoing ileostomy were similar to, but higher than those previously reported in the colorectal literature. In our population, patients with preexisting cardiovascular or renal disease were at the highest risk of readmission and may benefit from preemptive strategies to decrease high ostomy output and dehydration.

Original languageEnglish (US)
Pages (from-to)561-565
Number of pages5
JournalGynecologic oncology
Volume134
Issue number3
DOIs
StatePublished - Jan 1 2014

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Ileostomy
Dehydration
Neoplasms
Ostomy
Kidney
Patient Readmission
Anastomotic Leak
Chronic Renal Insufficiency
Acute Kidney Injury
Ovarian Neoplasms
Creatinine
Hypertension
Survival
Water
Wounds and Injuries
Serum
Population

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Postoperative readmissions following ileostomy formation among patients with a gynecologic malignancy. / Glasgow, Michelle A.; Shields, Kristin; Vogel, Rachel Isaksson; Teoh, Deanna; Argenta, Peter A.

In: Gynecologic oncology, Vol. 134, No. 3, 01.01.2014, p. 561-565.

Research output: Contribution to journalArticle

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abstract = "Ileostomy results in a relatively poorer water reabsorption and is associated with dehydration and renal injury. These problems may be exacerbated in the setting of gynecologic cancers owing to both patient and disease-related factors. We evaluated the rate and reasons for hospital readmission within 30 days of ileostomy creation in patients with a gynecologic malignancy. We performed a retrospective review of women with gynecologic malignancies who underwent ileostomy creation between 2002 and 2013. Fifty-three patients were eligible for analysis. The mean age was 63.3 years. Most patients had ovarian cancer (86.5{\%}). Indications for ileostomy included small bowel obstruction (45.3{\%}), as part of primary debulking (18.9{\%}), or treatment of an anastomotic leak (15.1{\%}). The 30-day readmission rate was 34{\%}. Co-morbid diseases such as hypertension (p=0.008) and chronic kidney disease (p=0.010) were more common among women who were readmitted. The most common reasons for readmission were dehydration (38.9{\%}) and acute renal failure (33.3{\%}); women readmitted for these conditions had higher average serum creatinine levels at initial postoperative discharge (1.00 mg/dL versus 0.71 mg/dL, p=0.017) than women who did not require readmission. Readmitted women had a trend toward shorter overall survival (0.41 years versus 1.67 years, p=0.061). Readmission rates for gynecologic oncology patients undergoing ileostomy were similar to, but higher than those previously reported in the colorectal literature. In our population, patients with preexisting cardiovascular or renal disease were at the highest risk of readmission and may benefit from preemptive strategies to decrease high ostomy output and dehydration.",
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