High rates of complications and rehospitalizations after abdominal ostomy surgery (A mostly preventable 42%)

Medical Xpress / Wolters Kluwer Health / Journal of Wound, Ostomy & Continence Nursing ^ | Nov. 29, 2022 | Laura L. Schott et al

[ConservativeMind]

Patients undergoing abdominal surgery for ostomy placement have high rates of hospital readmissions—often involving ostomy-related complications, reports a study.

Colostomies and ileostomies are openings created in the abdominal wall to allow passage of stool from the large and small intestines, respectively. Urostomies are created to allow passage of urine from the bladder. Among the study patients, the most common reasons for colostomy or ileostomy were colorectal cancer, diverticulitis, and sepsis. Bladder cancer was the main reason for urostomy.

The data showed high rates of healthcare use in the weeks and months after stoma surgery. Within 120 days after initial hospitalization, 42% of patients were readmitted to the hospital at least once. Patients undergoing ileostomy frequently had repeat hospitalizations: 52%, compared to 36% in the colostomy group and 35% in the urostomy group. Ostomy complications were the reason for rehospitalization in about 62% of patients.

About 21% of patients had ED visits within 120 days after initial hospitalization—more common for colostomy or ileostomy patients, compared to urostomy patients. About 40% of ED visits were due to ostomy-related complications.

"To address these issues, clinicians and hospital management should ensure patients receive the services of a [wound, ostomy and continence] WOC or ostomy nurse specialist, preoperative stoma marking, and post-discharge support programs that promote self-management skills and adjustment to life with an ostomy," Dr. Schott and coauthors write. They note that about two-thirds of patients were discharged home from the hospital, with or without home health care.

"Timely clinical follow-up after discharge may contribute to early identification and management of modifiable factors increasing risk for stomal or peristomal complications and thereby may decrease readmissions and subsequent ED visits," the researchers add. Other priorities include reducing the frequency of unplanned ostomy surgery and providing presurgical education for all patients undergoing an ostomy.

[ConservativeMind]

Even if the initial reason for such surgery can’t be planned for, the beautiful thing is that clear preventative measures can bring the complication surgeries down from an incredibly high percentage.

[ConservativeMind]

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[amihow]

Drs. CUt and Run?

[wally_bert]

I had the osteomy misadventure.

So far so good since repaired a few weeks ago.

[George from New England]

Are we talking any percentage of these triggered by bad colonscopy ??

[TribalPrincess2U]

I wouldn’t be surprised if that was another possibility.

[Texan]

Twenty-one years ago my husband had bladder cancer which resulted in an urostomy.

Over the years he's had three resulting hertnia surgeries the most extensive being an abdominal wall reconstruction. The most serious result from having the urostomy has been 5 cases of life-threatening sepsis. He's now antibiotic resistant. The infectious disease doctor told me that one of these days the sepsis would likely get him.