Analysis of risk factors for anastomotic infectious complications following bowel resection for Crohn disease / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the risk factors for anastomotic infectious complications after bowel resection in patients with Crohn disease.</p><p><b>METHODS</b>Clinical data of 124 patients with Crohn disease undergoing bowel resection between January 1990 and October 2012 were analyzed retrospectively. The risk factors were identified by χ(2) test and Logistic regression.</p><p><b>RESULTS</b>Fourteen patients (12.3%, 14/114) developed anastomotic infectious complications in the postoperative period, including anastomotic leak (n=7), intra-abdominal abscess (n=6), and enterocutaneous fistula (n=1). Crohn disease activity index (CDAI)>150 (OR=2.185, 95%CI1.098-6.256, P=0.040), steroid usage (OR=2.674, 95%CI1.118-8.786, P=0.027), and the presence of preoperative abscess/fistula (OR=3.447, 95%CI1.254-10.462, P=0.014) were identified as independent risk factors of anastomotic infectious complications. In the absence of these 3 risk factors, the rate of anastomotic infectious complication was 5.7% (3/53), which increased to 11.4% (4/35) when one risk factor was present, 21.1% (4/19) when two risk factors were present, and 42.9% (3/7) when all the 3 risk factors were present.</p><p><b>CONCLUSIONS</b>CDAI>150, steroid usage and preoperative abscess/fistula are associated with higher rates of anastomotic infectious complications following bowel resection for Crohn disease. A prudent management should be carried out if risk factors can not be eliminated preoperatively.</p>