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28.11.2016 | Original Article | Ausgabe 2/2017

Journal of Gastrointestinal Surgery 2/2017

Bowel Preparation Is Associated with Reduced Morbidity in Elderly Patients Undergoing Elective Colectomy

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 2/2017
Autoren:
Scott C. Dolejs, Michael J. Guzman, Alyssa D. Fajardo, Bruce W. Robb, Bryan K. Holcomb, Ben L. Zarzaur, Joshua A. Waters
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11605-016-3314-9) contains supplementary material, which is available to authorized users.

Abstract

Background

Bowel preparation in elderly patients is associated with physiologic derangements that may result in postoperative complications. The aim of this study is to determine the impact of bowel preparation on postoperative outcomes in elderly patients.

Methods

Patients age 75 years and older who underwent elective colectomy were identified from the 2012–2014 American College of National Surgical Quality Improvement Program (ACS-NSQIP database). Patients were grouped into no bowel preparation, mechanical bowel preparation (MBP), oral antibiotic preparation (OABP), or combined MBP + OABP. Logistic regression modeling was conducted to calculate risk-adjusted 30-day outcomes.

Results

There were 4829 patients included in the analysis. Morbidity was 34.3% in no bowel prep, 32.4% in MBP, 24.8% in OABP, and 24.6% in MBP + OABP groups (p < 0.001). The MBP + OABP group compared with no bowel prep was associated with reduced rates of anastomotic leak, ileus, superficial surgical site infection (SSI), organ space SSI, respiratory compromise, and reduced length of stay. There was no difference in the rate of acute kidney injury between the groups.

Conclusion

MBP + OABP was associated with reduced morbidity compared with no bowel preparation in elderly patients undergoing elective colorectal resection. MBP alone was not associated with differences in outcomes compared with no bowel preparation. The use of MBP + OABP is safe and effective in elderly patients undergoing elective colectomy.

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