Hospital readmission for fluid and electrolyte abnormalities following ileostomy construction: preventable or unpredictable? Journal Article

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Authors: Hayden, D. M.; Pinzon, M. C.; Francescatti, A. B.; Edquist, S. C.; Malczewski, M. R.; Jolley, J. M.; Brand, M. I.; Saclarides, T. J.
Article Title: Hospital readmission for fluid and electrolyte abnormalities following ileostomy construction: preventable or unpredictable?
Abstract: BACKGROUND: Ileostomy creation has complications, including rehospitalization for fluid and electrolyte abnormalities. Although studies have identified predictors of this morbidity, readmission rates remain high. METHODS: The researchers conducted a retrospective chart review of all patients with ileostomy creation at a tertiary institution from January 2008 to June 2011. RESULTS: One hundred fifty-four patients (154) were included in this study; 71 (46.1 %) were female. Mean age was 49 +/- 17.64 (range 16-91), and mean BMI was 26.9 +/- 6.44 (range 13-52). The readmission rate for fluid and electrolyte abnormalities was 20.1 % for the study population; of those readmitted for all diagnoses, dehydration accounted for 40.7 % of all readmissions. Cancer was associated with readmission (chi(2) = 4.73, p = 0.03) as was neoadjuvant therapy (chi(2) = 9.20, p = 0.01). After multivariate analysis, only the use of anti-diarrheals and neoadjuvant therapy remained significant. High stoma output, adjuvant treatment, and postoperative complications were not significant. CONCLUSIONS: Our study found that the use of anti-diarrheals and neoadjuvant therapy for rectal cancer were associated with readmission. Our findings imply that the use of anti-diarrheals may be a marker for patients at risk for fluid and electrolyte abnormalities; these patients should be strictly monitored at home. Our study also suggests consideration of avoidance of ileostomy creation or different discharge criteria for at-risk patients. Prospective studies focused on stoma monitoring after discharge may help reduce rehospitalizations for fluid and electrolyte abnormalities after ileostomy creation.
Journal Title: Journal of Gastrointestinal Surgery
Volume: 17
Issue: 2
ISSN: 1873-4626
Publisher: Unknown  
Journal Place: United States
Date Published: 2013
Start Page: 298
End Page: 303
Language: eng
DOI/URL:

10.1007/s11605-012-2073-5

10.1007/s11605-012-2073-5
Notes: JID: 9706084; 2012/05/22 [received]; 2012/10/29 [accepted]; 2012/11/29 [aheadofprint]; ppublish
LUC Authors
  1. Theodore Saclarides
    14 Saclarides
  2. Dana Hayden
    10 Hayden
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