Significant risk factors in elective colorectal surgery
A prospective study of 618 patients undergoing elective colorectal surgery performed in a district general hospital over a 10-year period is reported. Multivariate analysis has been used in an attempt to identify risk factors. The risk of wound infection was increased if septicaemia, respiratory sep...
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| Veröffentlicht in: | Annals of the Royal College of Surgeons of England 1995-09, Vol.77 (5), p.369-371 |
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| container_title | Annals of the Royal College of Surgeons of England |
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| creator | Kingston, R D Walsh, S Robinson, C Jeacock, J Keeling, F |
| description | A prospective study of 618 patients undergoing elective colorectal surgery performed in a district general hospital over a 10-year period is reported. Multivariate analysis has been used in an attempt to identify risk factors. The risk of wound infection was increased if septicaemia, respiratory sepsis or faecal contamination was present, if the surgeon was a consultant and if increased risk of serious complications if the patient was male and of poor physical status. Operative mortality was significantly associated with poor physical status, respiratory sepsis and intra-abdominal abscess. Only three risk factors could be identified preoperatively: patient gender, physical status and seniority of surgeon. However, procedures low in the pelvis are more difficult and in this study group are also associated with a higher risk of wound infection. The majority of these procedures are performed by consultants. In addition, this study group has proportionally more female patients of poor physical status who are selectively being operated on by the consultant, seemingly indicating the 'consultant' as a risk factor. |
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Multivariate analysis has been used in an attempt to identify risk factors. The risk of wound infection was increased if septicaemia, respiratory sepsis or faecal contamination was present, if the surgeon was a consultant and if increased risk of serious complications if the patient was male and of poor physical status. Operative mortality was significantly associated with poor physical status, respiratory sepsis and intra-abdominal abscess. Only three risk factors could be identified preoperatively: patient gender, physical status and seniority of surgeon. However, procedures low in the pelvis are more difficult and in this study group are also associated with a higher risk of wound infection. The majority of these procedures are performed by consultants. In addition, this study group has proportionally more female patients of poor physical status who are selectively being operated on by the consultant, seemingly indicating the 'consultant' as a risk factor.</description><identifier>ISSN: 0035-8843</identifier><identifier>EISSN: 1478-7083</identifier><identifier>PMID: 7486765</identifier><language>eng</language><publisher>England: Royal College of Surgeons of England</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colon - surgery ; Elective Surgical Procedures - mortality ; Female ; Hospitals, District ; Hospitals, General ; Humans ; Male ; Medical Staff, Hospital ; Middle Aged ; Multivariate Analysis ; Postoperative Complications - mortality ; Prospective Studies ; Rectum - surgery ; Risk Factors ; Surgical Wound Infection - etiology</subject><ispartof>Annals of the Royal College of Surgeons of England, 1995-09, Vol.77 (5), p.369-371</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2502412/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2502412/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7486765$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kingston, R D</creatorcontrib><creatorcontrib>Walsh, S</creatorcontrib><creatorcontrib>Robinson, C</creatorcontrib><creatorcontrib>Jeacock, J</creatorcontrib><creatorcontrib>Keeling, F</creatorcontrib><title>Significant risk factors in elective colorectal surgery</title><title>Annals of the Royal College of Surgeons of England</title><addtitle>Ann R Coll Surg Engl</addtitle><description>A prospective study of 618 patients undergoing elective colorectal surgery performed in a district general hospital over a 10-year period is reported. Multivariate analysis has been used in an attempt to identify risk factors. The risk of wound infection was increased if septicaemia, respiratory sepsis or faecal contamination was present, if the surgeon was a consultant and if increased risk of serious complications if the patient was male and of poor physical status. Operative mortality was significantly associated with poor physical status, respiratory sepsis and intra-abdominal abscess. Only three risk factors could be identified preoperatively: patient gender, physical status and seniority of surgeon. However, procedures low in the pelvis are more difficult and in this study group are also associated with a higher risk of wound infection. The majority of these procedures are performed by consultants. In addition, this study group has proportionally more female patients of poor physical status who are selectively being operated on by the consultant, seemingly indicating the 'consultant' as a risk factor.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Colon - surgery</subject><subject>Elective Surgical Procedures - mortality</subject><subject>Female</subject><subject>Hospitals, District</subject><subject>Hospitals, General</subject><subject>Humans</subject><subject>Male</subject><subject>Medical Staff, Hospital</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Postoperative Complications - mortality</subject><subject>Prospective Studies</subject><subject>Rectum - surgery</subject><subject>Risk Factors</subject><subject>Surgical Wound Infection - etiology</subject><issn>0035-8843</issn><issn>1478-7083</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE1LAzEYhIMotVZ_grAnbwv53CQXQYpfIHiw95BN3tRouqnJbqH_3oJF9DQDMzwDc4LmhEvVSqzYKZpjzESrFGfn6KLWD4yJlorM0Exy1clOzJF8i-shhujsMDYl1s8mWDfmUps4NJDAjXEHjcspl4O3qalTWUPZX6KzYFOFq6Mu0OrhfrV8al9eH5-Xdy_tlnZkbGmg3HdB9MC0sEyQ4JRg2ocOS6a854JYxaWnPoDUvdCCKqG9d6oPngNboNsf7HbqN-AdDGOxyWxL3NiyN9lG8z8Z4rtZ552hAlNO6AFwcwSU_DVBHc0mVgcp2QHyVI2UndZMyUPx-u_S78TxKfYNLuRnug</recordid><startdate>19950901</startdate><enddate>19950901</enddate><creator>Kingston, R D</creator><creator>Walsh, S</creator><creator>Robinson, C</creator><creator>Jeacock, J</creator><creator>Keeling, F</creator><general>Royal College of Surgeons of England</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19950901</creationdate><title>Significant risk factors in elective colorectal surgery</title><author>Kingston, R D ; Walsh, S ; Robinson, C ; Jeacock, J ; Keeling, F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p261t-2f24d6f5be395a351fc8539df60738dd451a847d2dfe79b5952859ddc8bfd4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Colon - surgery</topic><topic>Elective Surgical Procedures - mortality</topic><topic>Female</topic><topic>Hospitals, District</topic><topic>Hospitals, General</topic><topic>Humans</topic><topic>Male</topic><topic>Medical Staff, Hospital</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Postoperative Complications - mortality</topic><topic>Prospective Studies</topic><topic>Rectum - surgery</topic><topic>Risk Factors</topic><topic>Surgical Wound Infection - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kingston, R D</creatorcontrib><creatorcontrib>Walsh, S</creatorcontrib><creatorcontrib>Robinson, C</creatorcontrib><creatorcontrib>Jeacock, J</creatorcontrib><creatorcontrib>Keeling, F</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of the Royal College of Surgeons of England</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kingston, R D</au><au>Walsh, S</au><au>Robinson, C</au><au>Jeacock, J</au><au>Keeling, F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Significant risk factors in elective colorectal surgery</atitle><jtitle>Annals of the Royal College of Surgeons of England</jtitle><addtitle>Ann R Coll Surg Engl</addtitle><date>1995-09-01</date><risdate>1995</risdate><volume>77</volume><issue>5</issue><spage>369</spage><epage>371</epage><pages>369-371</pages><issn>0035-8843</issn><eissn>1478-7083</eissn><abstract>A prospective study of 618 patients undergoing elective colorectal surgery performed in a district general hospital over a 10-year period is reported. Multivariate analysis has been used in an attempt to identify risk factors. The risk of wound infection was increased if septicaemia, respiratory sepsis or faecal contamination was present, if the surgeon was a consultant and if increased risk of serious complications if the patient was male and of poor physical status. Operative mortality was significantly associated with poor physical status, respiratory sepsis and intra-abdominal abscess. Only three risk factors could be identified preoperatively: patient gender, physical status and seniority of surgeon. However, procedures low in the pelvis are more difficult and in this study group are also associated with a higher risk of wound infection. The majority of these procedures are performed by consultants. In addition, this study group has proportionally more female patients of poor physical status who are selectively being operated on by the consultant, seemingly indicating the 'consultant' as a risk factor.</abstract><cop>England</cop><pub>Royal College of Surgeons of England</pub><pmid>7486765</pmid><tpages>3</tpages></addata></record> |
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| identifier | ISSN: 0035-8843 |
| ispartof | Annals of the Royal College of Surgeons of England, 1995-09, Vol.77 (5), p.369-371 |
| issn | 0035-8843 1478-7083 |
| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Aged, 80 and over Colon - surgery Elective Surgical Procedures - mortality Female Hospitals, District Hospitals, General Humans Male Medical Staff, Hospital Middle Aged Multivariate Analysis Postoperative Complications - mortality Prospective Studies Rectum - surgery Risk Factors Surgical Wound Infection - etiology |
| title | Significant risk factors in elective colorectal surgery |
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