Factors associated with emergent colectomy in patients with neutropenic enterocolitis. View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-04-05

AUTHORS

Omar Vergara-Fernández, Mario Trejo-Avila, Danilo Solórzano-Vicuña, Oscar Santes, Noel Salgado-Nesme

ABSTRACT

PURPOSE: Neutropenic enterocolitis (NEC) is a severe complication of neutropenia. NEC is characterized by segmental ulceration, intramural inflammation, and necrosis. Factors present in patients who underwent colectomy have never been studied. The present study aimed to describe the clinical factors present in patients who underwent emergent colectomy for the treatment of neutropenic enterocolitis. METHODS: Patients admitted with neutropenic enterocolitis from November 2009 to May 2018 were retrospectively analyzed. Logistic regression analysis was used to determine clinical factors associated with emergent colectomy. RESULTS: Thirty-nine patients with NEC were identified. All patients had a hematological disorder. Medical treatment was the only management in 30 (76.9%) patients, and 9 (23.1%) patients underwent colectomy. No differences were found between the treatment groups regarding sex, age, or comorbidities. Patients were more likely to undergo colectomy if they developed abdominal distention (OR = 12, p = 0.027), hemodynamic failure (OR = 6, p = 0.042), respiratory failure (OR = 17.5, p = 0.002), multi-organic failure (OR = 9.6, p = 0.012), and if they required ICU admission (OR = 11.5, p = 0.007). Respiratory failure was the only independent risk factor for colectomy in multivariable analysis. In-hospital mortality for the medical and surgical treatment groups was 13.3% (n = 4) and 44.4% (n = 4), respectively (p = 0.043). CONCLUSIONS: In our study, most NEC patients were treated conservatively. Patients were more likely to undergo colectomy if they developed organ failures or required ICU admission. Early surgical consultation is suggested in all patients with NEC. More... »

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00423-019-01781-2

DOI

http://dx.doi.org/10.1007/s00423-019-01781-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113261729

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30953135


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