Predictors of dehydration and acute renal failure in patients with diverting loop ileostomy creation after colorectal surgery

Table 1 Characteristics of patients with diverting loop ileostomy after colorectal surgery

	N-HORC (n = 78)	HORC (n = 24)	P < 0.05
Sex			0.913
Female	40 (51.3)	12 (50)
Male	38 (48.7)	12 (50)
Age, n (%)			0.475
< 59 yr	39 (50)	14 (58.3)
≥ 60 yr	39 (50)	10 (41.7)
BMI, n (%)			0.919
< 29.9	72 (92.3)	22 (91.7)
≥ 30	6 (7.7)	2 (8.3)
Smoking, n (%)			0.779
Yes	30 (38.5)	10 (41.7)
Diabetes mellitus, n (%)			0.459
Yes	11 (14.1)	2 (8.3)
Hypertension, n (%)			0.829
Yes	21 (26.9)	7 (29.2)
Charlson morbidity index			0.985
0-1	29 (37.2)	9 (37.5)
2-3	25 (32.1)	7 (29.2)
4-5	19 (24.4)	6 (25)
≥ 6	5 (6.4)	2 (8.3)
Colorectal diagnosis, n (%)
Rectal cancer	33 (42.3)	6 (25)	0.127
Colon cancer	7 (9)	3 (12.5)	0.611
Ulcerative colitis	5 (6.4)	6 (25)	0.010
Diverticular disease	24 (30.7)	9 (37.5)	0.537
FAP	9 (11.6)	0	0.111
Previous abdominal surgery, n (%)	14 (17.9)	2 (8.3)	0.257
Yes
Previous Treatments, n (%)
Steroids	8 (10.3)	8 (33.3)	0.007
Immunomodulator	2 (2.6)	3 (12.5)	0.049
Biologics (anti-TNF)	1 (1.3)	2 (8.3)	0.074
Radiotherapy	28 (35.9)	6 (25)	0.322
Chemotherapy	33 (42.3)	7 (29.2)	0.249
Index surgery, n (%)			0.078
Elective	59 (75.6)	13 (54.2)
Urgent	19 (24.4)	11 (45.8)
Modality of index surgery, n (%)			0.244
Open	52 (66.7)	19 (79.2)
Laparoscopic	26 (33.3)	5 (20.8)
Complications after index surgery, n (%)	17 (21.8)	11 (45.8)	0.021
Yes
Re-intervention after index surgery, n (%)	13 (16.7)	7 (29.2)	0.177
Yes
Ileostomy output at discharge, n (%)	21 (26.9)	13 (54.2)	0.013
≥ 1000 mL
Discharge with loperamide, n (%)	29 (37.2)	15 (62.5)	0.029
Yes
Time until ileostomy closure, n (%)			0.038
< 3 mo	9 (11.5)	7 (29.2)
> 3 mo	69 (88.5)	17 (70.8)

N-HORC: Non-high output related complications group; HORC: High output related complications group; BMI: Body mass index; ASA: American Society of Anesthesiologists; IQR: Interquartile range.

Table 2 Characteristics of patients with high output related complications (high-output-related complications group)

	HORC group (n = 24)
Number of visits to the ED, mean (range)	1.6 (1-4)
Time from index surgery to first visit to the ED (d), mean (range)	78.3 (3-360)
Number of readmissions to the hospital, mean (range)	1 (1-2)
Presentation with acute renal failure, n (%)
Yes	18 (75)
No	6 (25)
Presentation with dehydration or electrolyte imbalances, n (%)
Yes	19 (79.2)
No	5 (20.8)

HORC: High-output-related complications; ER: Emergency department.

Table 3 Univariate and multivariate analysis of clinical factors associated with high-output related complications (dehydration and acute renal failure)

Factors	Univariate analysis		Multivariate analysis
	OR (95%CI)	P value	OR (95%CI)	P value
Index surgery	1.0
Elective
Urgent	2.6 (1.01-8.82)	0.047
Complications after index surgery	3 (1.15-7.97)	0.024
Yes
Ulcerative Colitis	4.8 (1.33-17.75)	0.017	7.6 (1.81-31.95)	0.006
Immunomodulators	5.4 (0.85-34.63)	0.074
Steroids	4.3 (1.42-13.41)	0.010
Biologics (anti-TNF)	7 (0.60-80.85)	0.119
Ileostomy output at discharge ≥ 1000 mL/24 h	3.2 (1.24-8.26)	0.016	3.3 (1.18-9.37)	0.023
Discharge with loperamide	2.8 (1.09-7.24)	0.032
Yes

The reference category has an odds ratio of 1.0. For multivariable backward logistic regression analysis, odds ratio (OR) and 95% confidence interval (CI) are presented, and only significant results are shown.