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Investigation of treatment and analysis of prognostic risk on intra-abdominal fistula in China: a multicenter prospective study / 中国医师杂志
Journal of Chinese Physician ; (12): 805-809, 2020.
Article in Chinese | WPRIM | ID: wpr-867323
ABSTRACT

Objective:

To investigate the diagnosis and treatment for intra-abdominal fistula in China, and to explore the prognostic factors.

Methods:

A multi-center cross-sectional study was conducted based on the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections to collect the clinical data of patients with intra-abdominal fistula from 18 medical centers from January 1, 2018 to December 31, 2018, including basic information, medical records and prognosis.

Results:

A total of 106 patients were enrolled in this study, including 57 males and 49 females, with an average age of (48.0±17.8)years. The most common type of intra-abdominal fistula was entero-vesical fistula (34.0%), followed by entero-vaginal fistula (31.1%), entero-enteric fistula (26.4%) and multiple fistula (8.5%). The direct causes of intra-abdominal fistula were mainly surgical operation (66.0%), followed by spontaneous fistula due to Crohn′s disease (18.9%), radiation intestinal injury (11.3%), and 4 cases (3.8%) of unknown reasons. During the whole treatment, 95 patients received nutritional support therapy, mainly EN+ PN (75.8%). Finally, 86 patients (81.1%) received surgical treatment, with a healing rate of 95.3%. After surgery, 8.1% of patients developed surgical site infections (SSI), and 10.5% had a relapse of fistula. 20 patients (18.9%) were treated conservatively, with a self-healing rate of 80.0%. The overall mortality rate was 8.5%, and the highest mortality (15.2%) was found in entero-enteric fistula. Statistical analysis showed that the age ( t=-4.664, P<0.001), leucocyte level ( U=663.000, P=0.010), sepsis ( P=0.002) and multiple organ dysfunction syndrome (MODS) ( P=0.019) were higher in the death group than those in the healing group. Multivariate analysis suggested that advanced age ( OR=1.073, 95% CI 1.008-1.141, P=0.026) and complications of sepsis ( OR=11.806, 95% CI 1.064-131.048, P=0.044) were independent risk factors of the death for patients with intra-abdominal fistula.

Conclusions:

The overall mortality rate of intra-abdominal fistula is still high, and malignant tumor is the most common primary disease. Advanced age and sepsis are independent risk factors for death in patients with intra-abdominal fistula.
Full text: Available Index: WPRIM (Western Pacific) Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Language: Chinese Journal: Journal of Chinese Physician Year: 2020 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Language: Chinese Journal: Journal of Chinese Physician Year: 2020 Type: Article