Factors that predict complications after construction of a stoma: a retrospective study

OBJECTIVE

To find out our incidence of complications of stoma surgery and identify variables that predict outcome.

DESIGN

Retrospective study.

SETTING

Teaching hospital, Scotland.

SUBJECTS

All 121 patients who had 126 stomas constructed during 1996.

INTERVENTIONS

Follow up until the end of 1999.

MAIN OUTCOME MEASURES

Morbidity and mortality.

RESULTS

There were 64 men and 57 women, median age 58 years, range 16-83. Forty-three stomas were constructed for malignancy (34%). Forty-two stomas were raised during emergency operations (33%). Colorectal surgeons created 96 stomas (76%). Sixty-one of 92 potentially reversible stomas were closed (66%). Two patients died (2%) perioperatively. Overall stoma-related morbidity was 68% (n = 85). The rate of major stoma-related complications was 26% (n = 33). Nine major complications resulted in a reoperation rate of 7%. On univariate analysis, age, American Society of Anesthesiologists (ASA) grade, and surgeon's speciality were significant predictive variables of major stomal complications (p < or = 0.002, 0.02, and 0.05 respectively). Multivariate analysis showed that the age of the patient was the only factor that independently influenced the outcome of stoma surgery (p < or = 0.001).

CONCLUSIONS

Optimising the perioperative health status of the patients, particularly the elderly, may reduce morbidity. The results also support specialist surgical care of patients undergoing stomal surgery.