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Incidence Rates and Predictors of Stomal-Related Complications: A 1-Year Prospective Study

Authors: Mei-Yu Hsu, MS; Hsiao-Hui Hsu, MS; Yu-Lin Wu, PhD, RN, WCET
BACKGROUND: Stomal-related complications (SRCs) increase the health care burden and impair quality of life.

PURPOSE: To determine the incidence rates and predictors of stomal and peristomal complications (SCs and PCs, respectively).

METHODS: This was a prospective cohort study. In total, 215 patients who had undergone ostomy were enrolled and followed-up at 3, 30, 90, 180, and 360 days after surgery. During the follow-up period, SRCs were assessed by 1 colorectal surgeon and 2 wound, ostomy, and continence nurses. The SRCs were classified into SCs and PCs.

RESULTS: SRCs were observed in 105 patients (48.8%). The 105 patients had 145 SRCs (66 [45.5%] SCs and 79 [54.5%] PCs). A logistic regression analysis revealed that emergency surgery (odds ratio [OR]: 2.78; P = .041), laparoscopic surgery (OR: 2.91; P = .023), and inappropriate stomal location (OR: 19.23; P < .001) were significant predictors of SCs. Inappropriate stomal location also was significantly associated with PCs (OR: 7.70; P < .001). The cumulative incidence rate of SRCs was 73% in patients who underwent stomal surgery and were followed for 360 days.

CONCLUSIONS: Stomas created through emergency or laparoscopic surgery and those created at inappropriate sites were associated with a higher risk of SCs. Inappropriate stomal site was found to be a significant predictor for SCs and PCs.