Evidence map›Paper›PMID 39243310›Full record

ArticleInternational journal of colorectal disease2024

Reducing dehydration-induced readmissions post-colorectal surgery: the impact of a prevention bundle.

Ibrahim H Ozata, Tutku Tufekci, Tugce Aksan, Ecem Eren, Salih Nafiz Karahan, Mekselina Kalender, Yasar Baris Gulluoglu, Derya Salim Uymaz, Emre Ozoran, Ayise Karadag and 3 more

Abstract read
In one paragraph

Article in International journal of colorectal disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Ibrahim H OzataDepartment of General Surgery, Koc University School of Medicine, Istanbul, Türkiye. iozata@ku.edu.tr.
Tutku TufekciDepartment of General Surgery, Koc University School of Medicine, Istanbul, Türkiye.
Tugce AksanDepartment of General Surgery, Koc University Hospital, Istanbul, Türkiye.
Ecem ErenDepartment of General Surgery, Koc University Hospital, Istanbul, Türkiye.
Salih Nafiz KarahanDepartment of General Surgery, Koc University School of Medicine, Istanbul, Türkiye.
Mekselina KalenderDepartment of General Surgery, Koc University School of Medicine, Istanbul, Türkiye.
Yasar Baris GulluogluDepartment of General Surgery, Koc University School of Medicine, Istanbul, Türkiye.
Derya Salim UymazDepartment of General Surgery, Koc University School of Medicine, Istanbul, Türkiye.
Emre OzoranDepartment of General Surgery, Koc University School of Medicine, Istanbul, Türkiye.
Ayise KaradagKoc University School of Nursing, Istanbul, Türkiye.
Ahmet RencuzogullariDepartment of General Surgery, Koc University School of Medicine, Istanbul, Türkiye.
Dursun BugraDepartment of General Surgery, Koc University School of Medicine, Istanbul, Türkiye.
Emre BalikDepartment of General Surgery, Koc University School of Medicine, Istanbul, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIleostomy, frequently created after colorectal resections, hinders the physiologic function of the colon and can lead to dehydration and acute kidney injury due to high stoma outputs. This study aimed to evaluate the effectiveness of preventive measures on ileostomy-induced dehydration and related readmissions in a high-volume unit.

methodsIn this prospective cohort study at a high-volume colorectal surgery department in Turkiye, the Prospective Ileostomy-induced Dehydration Prevention Bundle Project (PIDBP) was assessed from March 2021 to March 2022. The study enrolled patients undergoing colorectal surgery with ileostomy and involved comprehensive inpatient stoma care, education, and a structured post-discharge follow-up. The follow-up included the "Hydration follow-up scale" to monitor ileostomy output and related complications. The primary outcome was the readmission rate due to dehydration-related complications. The patients receiving the bundle intervention were compared with patients treated in the preceding year, focusing on the effectiveness of interventions such as dietary adjustments, fluid therapy, and pharmacological management.

resultsIn the study, 104 patients were analyzed, divided into 54 pre-bundle and 50 bundle group patients, with no significant differences in patient characteristics. While the overall readmission rate due to dehydration was 12.5%, a significant reduction in dehydration-related readmissions was observed in the bundle group compared to the pre-bundle group (2% vs. 22%, p = 0.002). Univariate analysis identified high stoma output (> 800 ml/24 h) (p < 0.001), chronic renal failure (CRF) (p = 0.01), postoperative ileus (p = 0.03), higher ASA status (p = 0.04), extended hospital stays (p = 0.03), and small bowel resections (especially in J-pouch patients) (p < 0.001) as significant predictors of readmission. Multivariate analysis revealed that the mean ileostomy output before discharge was the sole significant predictor of dehydration-related readmission (OR 1.01), with an optimal cutoff of 877.5 ml/day identified with an area under the curve (AUC) of 0.947, demonstrating high sensitivity (92.3%) and specificity (86.8%) in predicting readmission risk.

conclusionThe Prospective Ileostomy-induced Dehydration Prevention Bundle Project significantly reduced readmission rates after colorectal surgery.

Indexed as

DehydrationIleostomyPatient ReadmissionAgedColorectal SurgeryFemaleHumansMaleMiddle AgedPatient Care BundlesPostoperative ComplicationsProspective StudiesColorectal surgeryDehydrationIleostomyReadmission

Identifiers

PMID39243310
PMCPMC11380635

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.