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Tytuł:
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Abnormal vital signs after laparoscopic colorectal surgery: More common than you think.
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Autorzy:
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Twohig K; Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
Ajith A; Center for Research Informatics, University of Chicago, Chicago, IL, USA.
Mayampurath A; Department of Pediatrics, University of Chicago, Chicago, IL, USA.
Hyman N; Division of Colon and Rectal Surgery, University of Chicago, Chicago, IL, USA.
Shogan BD; Division of Colon and Rectal Surgery, University of Chicago, Chicago, IL, USA. Electronic address: .
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Źródło:
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American journal of surgery [Am J Surg] 2021 Mar; Vol. 221 (3), pp. 654-658. Date of Electronic Publication: 2020 Aug 15.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Belle Mead, NJ : Excerpta Medica
Original Publication: New York.
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MeSH Terms:
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Vital Signs*
Anastomotic Leak/*diagnosis
Colectomy/*adverse effects
Laparoscopy/*adverse effects
Proctocolectomy, Restorative/*adverse effects
Adult ; Aged ; Anastomotic Leak/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prevalence ; Retrospective Studies ; Survival Analysis
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Contributed Indexing:
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Keywords: Anastomotic leak; Colorectal surgery; Vital signs
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Entry Date(s):
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Date Created: 20200828 Date Completed: 20210402 Latest Revision: 20210402
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Update Code:
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20240105
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DOI:
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10.1016/j.amjsurg.2020.08.009
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PMID:
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32847687
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Background: Anastomotic leak is a feared complication. The presence of abnormal vital signs is often cited as an important overlooked predictive clue in retrospective settings once the diagnosis of leak has already been established. We aimed to determine the prevalence of abnormal vital signs following colorectal resection and assess its predictive value.
Methods: We retrospectively studied patients undergoing colorectal resection. The performance of vital signs in predicting anastomotic leak was assessed using discrete-time survival analysis and receiver operator characteristic curve.
Results: 1662 patients (841 laparoscopic, 821 open) were included. Clinical anastomotic leak was diagnosed in 50 patients (3.1%). 96.8% of patients of the entire cohort had at least one abnormal vital sign during their postoperative course. No individual vital sign was a strong predictor of anastomotic leak in either laparoscopic or open cohorts.
Conclusion: Vital sign abnormalities are extremely common following open and laparoscopic colorectal surgery and alone are poor predictors of anastomotic leak.
Competing Interests: Declaration of competing interest All authors report no conflicts of interest to disclose.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
