title: Patient-related factors influence the risk of developing intestinal stoma complications in early post-operative period.
abstract: BACKGROUND
  Few studies have investigated the risk factors associated with developing intestinal stoma complications using appropriate multivariable methods. We aimed to determine the prevalence of, and risk factors for, stomal complications.
  
  
  METHODS
  A retrospective, case-control methodology was used to investigate 12 explanatory variables and four outcome variables in 202 consecutive patients receiving stomas in a district general hospital in the United Kingdom between January 2013 and December 2014. Univariable and multivariable logistic regression were used to calculate odds ratios (ORs).
  
  
  RESULTS
  There were 69 complications (69/202; 34.2%) in the early post-operative period (median 12 months) in total, the most common being retraction (30.4%). Performance status (World Health Organization score 1 or more; OR 2.67; 95% confidence intervals (CIs) 1.33-5.33; P = 0.006) and body mass index (>30 kg/m2; OR 3.30; 95% CIs 1.61-6.78; P = 0.001) were significantly associated with developing complications in multivariable analysis. Surgery-related risk factors, such as time of day or week of operation and grade of surgeon, were not associated with the development of stoma complications. Thirty-eight patients (18.8%) died over the follow-up period, but mortality was not related to the development of stoma complications (1.01; 0.48-2.13, P = 0.98).
  
  
  CONCLUSIONS
  Patient-related risk factors influence the risk of developing a stoma complication more than surgery-related risk factors. Preoperative and post-operative interventions, planning, vigilance and management should be focussed to at-risk groups, particularly obese patients.
authors.affiliation: Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK.
authors.forename: Mohanraj
authors.initials: M
authors.lastname: Harilingam
authors.affiliation: Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK.
authors.forename: Joseph
authors.initials: J
authors.lastname: Sebastian
authors.affiliation: Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK.
authors.forename: Charlene
authors.initials: C
authors.lastname: Twum-Barima
authors.affiliation: Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK.|Department of General Surgery, Ain Shams University, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Boshnaq
authors.affiliation: Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK.
authors.forename: Sudhakar
authors.initials: S
authors.lastname: Mangam
authors.affiliation: Surgery, Kent and Canterbury Hospital, Canterbury, UK.
authors.forename: Amjad
authors.initials: A
authors.lastname: Khushal
authors.affiliation: Colorectal Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK.
authors.forename: Deya
authors.initials: D
authors.lastname: Marzouk
authors.affiliation: Colorectal Surgery, Queen Elizabeth the Queen Mother Hospital, Margate, UK.
authors.forename: George
authors.initials: G
authors.lastname: Tsavellas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery; D006801:Humans; D017567:Karnofsky Performance Status / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009765:Obesity; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality*; D011184:Postoperative Period; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D054047:Surgical Stomas / Q000009:adverse effects* / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology
keywords: intestinal diseases complications; obesity; risk factors; surgical stomas