title: Readmission for dehydration or renal failure after ileostomy creation.
abstract: BACKGROUND
  Ileostomy creation is a commonly performed operation in colorectal surgery; however, many patients develop complications such as dehydration postoperatively. Dehydration is often severe enough to warrant hospital readmission and may result in renal failure. The true incidence of this complication has not been well described.
  
  
  OBJECTIVE
  The aim of this study was to identify the rate of hospital readmission secondary to dehydration or renal failure within 30 days of ileostomy creation.
  
  
  METHODS
  Retrospective review of all patients undergoing ileostomy creation from 2007 to 2011 in a single colorectal practice of 4 surgeons was performed. Charts were reviewed to identify patients readmitted for dehydration or renal failure within 30 days of operation. Data were then analyzed to identify predictors of readmission, dehydration, and renal failure. Subset analysis compared patients readmitted with simple dehydration versus patients with renal failure.
  
  
  METHODS
  Two hundred one patients undergoing colorectal operations that included ileostomy creation within a 4-year period at a single institution for a variety of indications were included.
  
  
  METHODS
  The primary outcome measured was readmission for dehydration or renal failure.
  
  
  RESULTS
  We observed a 17% 30-day readmission rate for dehydration or renal failure following ileostomy creation. Age greater than 50 was identified as an independent predictor of readmission with renal failure, whereas IPAA was predictive of readmission for simple dehydration, but not renal failure. Patients admitted with renal failure had significantly longer hospital stays and median hospital charges after readmission in comparison with patients admitted with simple dehydration.
  
  
  CONCLUSIONS
  This study was limited by its retrospective nature and its limited sample size.
  
  
  CONCLUSIONS
  Hospital readmission due to dehydration or renal failure following ileostomy creation is common, with age >50 being the strongest predictor for renal failure. Appropriate strategies to decrease dehydration and renal failure following ileostomy creation need to be investigated.
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. ian.paquette@uc.edu
authors.forename: Ian M
authors.initials: IM
authors.lastname: Paquette
authors.forename: Patrick
authors.initials: P
authors.lastname: Solan
authors.forename: Janice F
authors.initials: JF
authors.lastname: Rafferty
authors.forename: Martha A
authors.initials: MA
authors.lastname: Ferguson
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Davis
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000601:surgery; D003681:Dehydration / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology