title: Postoperative Ileus--More than Just Prolonged Length of Stay?
abstract: OBJECTIVE
  Given that postoperative ileus is common in colectomy patients, we sought to examine the association of ileus with adverse events in this patient population.
  
  
  METHODS
  The ACS NSQIP puf file from 2012 to 2013 was queried for non-emergent colectomy cases. Predictors of other poor postoperative outcomes in patients who experienced postoperative ileus were assessed using chi-squared and multivariable regression analyses. Chi-squared analysis was used to assess for additive effects of ileus and other postoperative complications on mortality. p Values <0.05 were considered significant.
  
  
  RESULTS
  We identified 32,392 patients who underwent non-emergent colectomy. Longer length of stay, higher complication, reoperation, readmission, and mortality rates were identified in patients with ileus (p < 0.001 for all). Overall, 59% of patients with ileus had at least one adverse outcome, compared with 25% of patients without ileus (p < 0.001). Patients who developed ileus in the absence of other complications had an identical mortality rate to patients without ileus (1%). Additional complications led to incremental increases in mortality rates.
  
  
  CONCLUSIONS
  Patients with ileus and multiple complications are at significantly increased risk for adverse outcomes. Older patients with more comorbidity were found to be at risk for adverse outcomes in addition to ileus, begging the question of whether these patients may benefit from preoperative optimization.
authors.affiliation: University of Wisconsin Department of Surgery, 650 Highland Avenue, Madison, WI, 53792, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Tevis
authors.forename: Evie H
authors.initials: EH
authors.lastname: Carchman
authors.forename: Eugene F
authors.initials: EF
authors.lastname: Foley
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Harms
authors.forename: Charles P
authors.initials: CP
authors.lastname: Heise
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Kennedy
mesh_terms: D000328:Adult; D000368:Aged; D003082:Colectomy / Q000009:adverse effects*; D015897:Comorbidity; D005260:Female; D006801:Humans; D045823:Ileus / Q000453:epidemiology*; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D012044:Regression Analysis; D012086:Reoperation / Q000009:adverse effects; D012307:Risk Factors; D014481:United States / Q000453:epidemiology