Retrospective Cohort Study
Copyright ©The Author(s) 2019.
World J Gastrointest Surg. Apr 27, 2019; 11(4): 218-228
Published online Apr 27, 2019. doi: 10.4240/wjgs.v11.i4.218
Table 1 Baseline demographic and laboratory characteristics of patients undergoing elective colorectal resection overall and by bowel preparation method
MBP + OAB
MBP
No Prep
Overall
P value
Overall N (missing data)n = 163 (25%)n = 260 (39.9%)n = 229 (35.1%)n = 652 (100%)
Age (missing: 3/0.5%)
mean (SD)57.69 (14.69)60.61 (13.7)59.48 (15.64)59.48 (14.67)
Median606160610.26
Q1/Q347/6952/7149.25/7250/71
Age grouped n (%)
≥ 65 yr60 (37)104 (40.2)98 (43)262 (40.4)0.50
Gender (missing: 0%)
Female60 (36.8)110 (42.3)102 (44.5)272 (41.7)0.30
Male103 (63.2)150 (57.7)127 (55.5)380 (58.3)
BMI (missing: 2/0.3%)
Mean (SD)28.65 (6.81)28.94 (7.43)28.52 (6.74)28.72 (7.04)
Median27.0527.6027.8927.750.96
Q1/Q324.23/32.0324.06/32.3523.4/32.2823.9/32.15
Race (missing: 0%)
White120 (73.6)214 (82.3)149 (65.1)483 (74.1)< 0.001
AA21 (12.9)11 (4.2)18 (7.9)50 (7.7)
Other or unknown22 (13.5)35 (13.5)62 (27.1)119 (18.3)
ASA score (missing: 0%)
1-no disturb3 (1.8)3 (1.2)9 (3.9)15 (2.3)0.34
2-mild disturb68 (41.7)110 (42.3)91 (39.7)269 (41.3)
3-severe disturb86 (52.8)139 (53.5)116 (50.7)341 (52.3)
≥ 4-life threat6 (3.7)8 (3.1)13 (5.7)27 (4.1)
Diabetes mellitus (missing: 0%)30 (18.4)30 (11.5)37 (16.2)97 (14.9)0.12
Preoperative steroid use (missing: 0%)23 (14.1)18 (6.9)25 (10.9)66 (10.1)0.05
Current smoking status (missing: 0%)33 (20.2)60 (23.1)40 (17.5)133 (20.4)0.31
Hypertension requiring treatment (missing: 0%)83 (50.9)125 (48.1)110 (48)318 (48.8)0.82
Preoperative weight loss > 10% in last six months (missing: 0%)15 (9.2)11 (4.2)9 (3.9)35 (5.4)0.04
Preoperative bleeding disorder (missing: 0%)5 (3.1)7 (2.7)5 (2.2)17 (2.6)0.86
Current procedural code
4414023 (14.1)56 (21.5)46 (20.1)125 (19.2)0.007
4414525 (15.3)39 (15)33 (14.4)97 (14.9)
4416015 (9.2)17 (6.5)34 (14.8)66 (10.1)
4420447 (28.8)53 (20.4)46 (20.1)146 (22.4)
4420520 (12.3)21 (8.1)28 (12.2)69 (10.6)
4420733 (20.2)74 (28.5)42 (18.3)149 (22.9)
Preoperative chemotherapy (missing: 2/0.3%)19 (11.8)20 (7.7)23 (10.0)62 (9.5)0.36
Continue in next page
Primary indication for surgery (missing: 0%)
Colon cancer68 (41.7)127 (48.8)112 (48.9)307 (47.1)0.06
Non-malignant polyp16 (9.8)32 (12.3)23 (10)71 (10.9)
Inflammatory bowel disease13 (8)9 (3.5)22 (9.6)44 (6.7)
Acute diverticulitis10 (6.1)14 (5.4)10 (4.4)34 (5.2)
Chronic diverticular disease37 (22.7)41 (15.8)27 (11.8)105 (16.1)
Other19 (11.7)37 (14.2)35 (15.3)91 (14)
Preoperative hematocrit (%) (missing: 30/4.6%)
n153 (93.9)247 (95)222 (96.9)622 (95.4)
mean (SD)38.95 (5.55)39.14 (5.48)38.36 (5.64)38.82 (5.56)
Median3939.53939.20.38
Q1/Q335.6/42.935.8/4334.1/4235.4/42.7
Preoperative white blood cells (K/cumm) (missing: 37/5.7%)
n150 (92)244 (93.8)221 (96.5)615 (94.3)
mean (SD)7.47 (2.71)7.52 (2.57)7.65 (2.43)7.56 (2.55)
Median7.177.37.10.48
Q1/Q35.68/8.85.7/8.846/95.8/8.9
Preoperative platelets (K/cumm) (missing: 39/6%)
n150 (92)244 (93.8)219 (95.6)613 (94)
mean (SD)265 (102)256 (91)267 (95)262 (95.42)
Median2532472582520.59
Q1/Q3203/301195/301206/304201/301
Preoperative serum albumin (g/dL) (missing: 243/37.3%)
n112 (68.7)164 (63.1)133 (58.1)409 (62.7)
mean (SD)3.83 (0.57)3.91 (0.53)3.89 (0.62)3.88 (0.57)0.50
Median3.9444
Q1/Q33.5/4.33.6/4.33.6/4.33.6-4.3
Preoperative blood urea nitrogen (mg/dL) (missing: 77/11.8%)
n149 (91.4)231 (88.8)195 (85.2)575 (88.2)
mean ± SD14.67 (8.99)15.32 (8.55)14.17 (6.20)14.8 (7.96)
Median131413140.18
Q1/Q310/16.411/1710/17.710/17
Table 2 Univariable logistic regression analyses to identify factors associated with reoperation as a treatment for postoperative anastomotic leak (n = 652)
Variable
Univariable logistic regression model
P-value
NWADuOR95%CI
Bowel Prep groups
MBP vs MBP + OAB1652 (100)1.140.77-1.700.51
Nothing vs MBP11.230.86-1.760.25
Nothing vs MBP + OAB11.410.94-2.110.10
Age < 65 vs ≥ 65 yr1649 (99.5)0.820.60-1.120.21
BMI ≥ 30 vs < 301650 (99.7)1.441.03-2.000.03
Female vs male652 (100)1.350.99-1.850.06
Non-White vs White652 (100)1.080.76-1.530.69
No DM vs DM1652 (100)0.850.55-1.310.46
No steroid vs steroids1652 (100)0.890.54-1.490.67
Hct (%) < 38 vs ≥ 381622 (95.4)0.930.67-1.290.68
WBC (K/cumm) ≤ 12 vs > 121615 (94.3)1.530.74-3.160.26
PLT (K/cumm) < 150 vs ≥ 1501613 (94)1.580.75-3.370.23
Albumin (g/dL) < 3.5 vs ≥ 3.51409 (62.7)1.130.70-1.830.62
BUN (mg/dL) > 20 vs ≤ 201575 (88.2)1.170.73-1.880.53
Table 3 Baseline characteristics of patients undergoing elective colorectal resection, categorized based on anastomosis leak management
Anastomosis leak treatment groups
Non-surgical (n = 300)Reoperation (n = 352)Total (n = 652)P-value
Age
NWAD (%)300 (100)349 (99.1)649 (99.5)0.891
mean ± SD59.38 ± 15.159.57 ± 14.3159.48 ± 14.67
Median (range) Q1/Q361 (19-88) 50/7160 (21-89) 51/7061 (19-89) 50/71
Height (inches)
NWAD (%)298 (99.3)352 (100)650 (99.7)0.191
mean ± SD66.39 ± 4.0266.8 ± 3.6866.61 ± 3.84
Median (range) Q1/Q366.5 (54-80) 64/6967 (57-76) 64/7067 (54-80) 64/69
Weight (lbs)
NWAD (%)299 (99.7)352 (100)651 (99.8)0.021
mean ± SD176 ± 44.29186 ± 51.7182 ± 48.65
Median (range) Q1/Q3172 (95-360) 144/201179 (83-469) 149/217175 (83-469) 145/208
BMI
NWAD (%)298 (99.3)352 (100)650 (99.7)0.131
mean ± SD27.99 ± 5.7929.34 ± 7.8928.72 ± 7.04
Median (range) Q1/Q327.12 (17.1-48.8) 23.9/31.328.1 (13.4-68.2) 23.9/33.327.75 (13-68) 23.9-32.15
Gender
Female137 (45.7)135 (38.4)272 (41.7)0.062
Male163 (54.3)217 (61.6)380 (58.3)
Race
White220 (73.3)263 (74.7)483 (74.1)0.692
Non-White80 (26.7)89 (25.3)169 (25.9)
DM
Yes48 (16)49 (13.9)97 (14.9)0.462
No252 (84)303 (86.1)555 (85.1)
Steroids use
Yes32 (10.7)34 (9.7)66 (10.1)0.672
No268 (89.3)318 (90.3)586 (89.9)
ASA Score
≤ 2133 (44.3)151 (42.9)284 (43.6)0.712
≥ 3167 (55.7)201 (57.1)368 (56.4)
Weight loss >10%
Yes13 (4.3)22 (6.3)35 (5.4)0.282
No287 (95.7)330 (93.7)617 (94.6)
PRTR
No300 (100)346 (98.3)646 (99.1)0.033
Yes0 (0)6 (1.7)6 (0.9)