title: Cytomegalovirus infection and postoperative complications in patients with ulcerative colitis undergoing colectomy.
abstract: BACKGROUND
  Ulcerative colitis (UC) can be complicated by reactivation of cytomegalovirus (CMV). CMV reactivation may change the course of UC and may require antiviral treatment. Some risk factors of CMV reactivation have previously been identified, whereas the association between CMV reactivation and postoperative complications has not been examined systematically.
  
  
  METHODS
  Patients with UC operated with colectomy due to active UC were studied (n = 77). Patient and disease characteristics, as well as postoperative complications were recorded and CMV was detected by immunohistochemical examination of multiple sections from the colectomy specimen.
  
  
  RESULTS
  CMV was found in nine (11.7%) colectomy specimens. CMV-positive patients received significantly higher doses of corticosteroids at colectomy than CMV-negative patients (61.1 ± 23 vs 32.5 ± 32 mg/day, p = 0.01). CMV-positive patients were also older, had a higher risk of severe complications, higher American Society of Anesthesiologists (ASA) score, longer preoperative stay, and a higher rate of acute surgery. Complications occurred in 30 (39%) patients after surgery, 8(10.4%) of whom were serious. Two CMV-positive patients (2.6%) died in-hospital after the colectomy. High ASA score was associated with the occurrence of serious complications.
  
  
  CONCLUSIONS
  A relatively small proportion of patients with UC operated by colectomy were CMV positive. CMV positivity was associated with old age, high dose of corticosteroids at operation, high ASA score, acute surgery, and severe postoperative complications. Patients with such characteristics may be at risk of CMV infection and may require special management.
authors.affiliation: Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU) , Trondheim , Norway.
authors.forename: Maya
authors.initials: M
authors.lastname: Olaisen
authors.forename: Astrid
authors.initials: A
authors.lastname: Rydning
authors.forename: Tom Christian
authors.initials: TC
authors.lastname: Martinsen
authors.forename: Ivar Skjåk
authors.initials: IS
authors.lastname: Nordrum
authors.forename: Patricia
authors.initials: P
authors.lastname: Mjønes
authors.forename: Reidar
authors.initials: R
authors.lastname: Fossmark
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000601:surgery* / Q000821:virology; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: colectomy; corticosteroids; cytomegalovirus; outcome; ulcerative colitis