title: Effects of ascites on outcomes of colorectal surgery in congestive heart failure patients.
abstract: BACKGROUND
  There are limited data regarding the effects of ascites on outcome of patients undergoing colorectal resection. We sought to identify complications related to ascites.
  
  
  METHODS
  The National Surgical Quality Improvement Program database was used to evaluate congestive heart failure (CHF) patients who had ascites before colorectal resection between 2005 and 2012. Multivariate regression analysis was performed to identify affected outcomes.
  
  
  RESULTS
  We sampled a total of 2,178 patients who suffered CHF and underwent colorectal resection, of which 195 (9%) had preoperative ascites. The mortality rate of patients who had preoperative ascites was 46.2% compared to 25.7% for patients without ascites (adjusted odd ratio [AOR], 3.38; P < .01). Complications affected by ascites include (P < .05) ventilator dependency (AOR, 2.40), acute renal failure (AOR, 2.18), and wound disruption (AOR, 2.44; P < .05). There was no increase in superficial surgical site infection rate in patients with ascites (AOR, 1.01; P = .9).
  
  
  CONCLUSIONS
  The presence of ascites in CHF patients is associated with increased mortality in patients undergoing colorectal surgery. There is no correlation between ascites and surgical site infection but wound disruption increases in the presence of ascites.
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Orange, CA, USA.
authors.forename: Zhobin
authors.initials: Z
authors.lastname: Moghadamyeghaneh
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Orange, CA, USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Carmichael
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Orange, CA, USA.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Mills
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Orange, CA, USA.
authors.forename: Alessio
authors.initials: A
authors.lastname: Pigazzi
authors.affiliation: Department of Surgery, School of Medicine, University of California, Irvine, 333 City Boulevard West, Suite 1600, Orange, CA, USA. Electronic address: mstamos@uci.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000150:complications*; D003082:Colectomy / Q000401:mortality; D003108:Colonic Diseases / Q000150:complications / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D057234:Preoperative Period; D012002:Rectal Diseases / Q000150:complications / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Ascites; Colorectal surgery; Congestive heart failure