Abstract

Background: Ileostomy formation is often performed in an acute setting with increased nutritional demands - presumed nutritional recovery has occurred at time of reversal. There is a paucity of data evaluating the effect of nutritional status on serious complications following loop ileostomy reversal in patients with inflammatory bowel disease (IBD). While ileostomy reversal is often considered a routine procedure relatively free of complications, we chose to evaluate our group of patients with IBD having this procedure and explored if measures of nutritional compromise at the time of reversal were associated with post-operative complications.

Methods: We retrospectively reviewed 359 patients with IBD who underwent ileostomy reversal. Demographics, clinical characteristics, and laboratory values were compared between patients stratified by serious 30-day post-operative complications.

Results: The overall median time to reversal was 13.1 weeks, (IQR 11-16), and this was comparable between those with and without serious complications. The overall serious complication rate was 22/359 (6.1%). Patients with serious complications had lower median albumin at time of reversal (3.3 vs 3.8; p = 0.049), higher incidence of anemia (68.4% vs 37.5%, p = 0.013) and greater interval decrease in BMI from time of ileostomy creation to closure (-2.1 vs -0.6; p = 0.03). Multivariate modeling demonstrated that for each integer increase in albumin, the odds of serious complication decreased by 59% (OR 0.41, 95% CI 0.20-0.83).

Conclusions: IBD patients are at unique increased risk for nutritional compromise. Patients with malnutrition may be at increased risk of serious complications following ileostomy reversal. Surgeons should consider routine assessment of nutritional status prior to surgery and some patients may benefit from delay for optimization prior to ileostomy reversal.

Keywords: Inflammatory Bowel Disease; Ileostomy Reversal; Malnutrition; Postoperative Complications; Colorectal Surgery

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Citation

Citation: Joel Bauer., et al. “Nutritional Factors Associated with Complications After Loop Ileostomy Reversal in Patients with Inflammatory Bowel Disease". Acta Scientific Gastrointestinal Disorders 4.1 (2021): 09-15.

Copyright

Copyright: © 2021 Selim Joel Bauer., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.