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

dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.departmentGraduate School of Health Sciences
dc.contributor.departmentSchool of Medicine
dc.contributor.departmentSchool of Nursing
dc.contributor.kuauthorAksan, Tuğçe
dc.contributor.kuauthorBalık, Emre
dc.contributor.kuauthorBuğra, Dursun
dc.contributor.kuauthorEren, Ecem
dc.contributor.kuauthorGüllüoğlu, Yaşar Barış
dc.contributor.kuauthorKalender, Mekselina
dc.contributor.kuauthorKaradağ, Ayişe
dc.contributor.kuauthorKarahan, Salih Nafiz
dc.contributor.kuauthorÖzata, İbrahim Halil
dc.contributor.kuauthorÖzoran, Emre
dc.contributor.kuauthorRencüzoğulları, Ahmet
dc.contributor.kuauthorTüfekçi, Tutku
dc.contributor.kuauthorUymaz, Derya Salim
dc.contributor.schoolcollegeinstituteGRADUATE SCHOOL OF HEALTH SCIENCES
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.contributor.schoolcollegeinstituteSCHOOL OF NURSING
dc.date.accessioned2025-03-06T20:58:39Z
dc.date.issued2024
dc.description.abstractIntroduction Ileostomy, 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. Methods In 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. Results In 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. Conclusion The Prospective Ileostomy-induced Dehydration Prevention Bundle Project significantly reduced readmission rates after colorectal surgery.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.identifier.doi10.1007/s00384-024-04709-5
dc.identifier.eissn1432-1262
dc.identifier.issn0179-1958
dc.identifier.issue1
dc.identifier.quartileQ1
dc.identifier.scopus2-s2.0-85203244643
dc.identifier.urihttps://doi.org/10.1007/s00384-024-04709-5
dc.identifier.urihttps://hdl.handle.net/20.500.14288/27527
dc.identifier.volume39
dc.identifier.wos1308299000002
dc.keywordsIleostomy
dc.keywordsDehydration
dc.keywordsReadmission
dc.keywordsColorectal surgery
dc.language.isoeng
dc.publisherSpringer
dc.relation.ispartofINTERNATIONAL JOURNAL OF COLORECTAL DISEASE
dc.subjectGastroenterology
dc.titleReducing dehydration-induced readmissions post-colorectal surgery: the impact of a prevention bundle
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorBuğra, Dursun
local.contributor.kuauthorBalık, Emre
local.contributor.kuauthorKaradağ, Ayişe
local.contributor.kuauthorRencüzoğulları, Ahmet
local.contributor.kuauthorÖzoran, Emre
local.contributor.kuauthorUymaz, Derya Salim
local.contributor.kuauthorGüllüoğlu, Yaşar Barış
local.contributor.kuauthorKalender, Mekselina
local.contributor.kuauthorKarahan, Salih Nafiz
local.contributor.kuauthorTüfekçi, Tutku
local.contributor.kuauthorÖzata, İbrahim Halil
local.contributor.kuauthorAksan, Tuğçe
local.contributor.kuauthorEren, Ecem
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1SCHOOL OF NURSING
local.publication.orgunit1GRADUATE SCHOOL OF HEALTH SCIENCES
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
local.publication.orgunit2School of Medicine
local.publication.orgunit2School of Nursing
local.publication.orgunit2Graduate School of Health Sciences
relation.isOrgUnitOfPublicationf91d21f0-6b13-46ce-939a-db68e4c8d2ab
relation.isOrgUnitOfPublication2f870f28-12c9-4b28-9465-b91a69c1d48c
relation.isOrgUnitOfPublicationd02929e1-2a70-44f0-ae17-7819f587bedd
relation.isOrgUnitOfPublicationcd883b5a-a59a-463b-9038-a0962a6b0749
relation.isOrgUnitOfPublication.latestForDiscoveryf91d21f0-6b13-46ce-939a-db68e4c8d2ab
relation.isParentOrgUnitOfPublication4c75e0a5-ca7f-4443-bd78-1b473d4f6743
relation.isParentOrgUnitOfPublication055775c9-9efe-43ec-814f-f6d771fa6dee
relation.isParentOrgUnitOfPublication17f2dc8e-6e54-4fa8-b5e0-d6415123a93e
relation.isParentOrgUnitOfPublication9781feb6-cb81-4c13-aeb3-97dae2048412
relation.isParentOrgUnitOfPublication.latestForDiscovery4c75e0a5-ca7f-4443-bd78-1b473d4f6743

Files