This article is more than 5 years old. Information may no longer be current.
Colectomy complication rates increased in children with UC
The rates of colectomy among children with ulcerative colitis in the US have remained stable between 1997 and 2009, while postoperative complication rates have increased significantly, according to recent findings.
Researchers utilized data from the Kids’ Inpatient Database to identify all children aged younger than 18 years with diagnostic codes of ulcerative colitis (UC) and a colectomy procedure code for 1997, 2000, 2003, 2006 and 2009. Poisson regression analysis was utilized to assess variations in colectomy rates. The researchers used multivariate logistic regression to evaluate rates of in-hospital postoperative complications and to determine predictors for postoperative complications.
Among pediatric UC patients (n=1,641), researchers determined that the annual colectomy rate was 0.43 per 100,000 person-years (95% CI, 0.38-0.47), a rate that remained steady throughout the study (P>.05). In 25% of the surgeries where postoperative complications occurred, the most common types were gastrointestinal related (13%) and infections (9.3%). A yearly increase in postoperative complications was observed at a rate of 1.1% annually between 1997 and 2009 (P=.01). The researchers, however, did not ascertain any other independent predictors of postoperative complications.
Children with postoperative complications had significantly longer median lengths of hospital stay (14.3 days vs. 8.2 days; P<.001) and also had higher median per-patient hospital costs ($81,567 vs. $55,461; P<.001) than patients without complications.
“Postoperative complications were associated with a significant burden to the health care with a longer length of stay and hospital charges per patient,” the researchers wrote. “To minimize postoperative complications, optimal management of UC requires close monitoring and timely decisions on colectomy.”
Disclosure: Kaplan reports serving as an advisory board member and speaker for Janssen, Abbvie and Schering-Plough. He has received research funding from Shire and Abbvie. deBruyn reports participating in advisory board meetings for Merck and Janssen and has received grant and travel support from Janssen.