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Gastrointestinal anastomotic leaks and risk factors in four university hospitals, Addis Ababa
Abstract
Background: Studies on the incidence and risk factors for anastomotic leak (AL) related to gastrointestinal (GI) surgery are mainly from the developed world. Incidences of AL range from 1.0% to 41.0%, varying widely according to the site, definition, and type of GI resection. Multiple risk factors have been identified. AL typically manifests clinically around the seventh postoperative day. It increases morbidity, mortality, hospital stay and extra costs irrespective of improvements in surgical techniques.
Objective: To identify the pattern, risk factors, and mortality rate related to GI anastomotic leaks after GI resection and anastomosis.
Methods: A retrospective descriptive study of medical records of 352 patients for ALs following GI tract resection and anastomosis at four university hospitals in Addis Ababa during January 1, 2017 to December 31, 2018 was done. Data were analyzed using SPSS version 23 package. Descriptive statistics and logistic regressions were used to analyze the data. A p-value of <0.05 was used to define statistical significance.
Results: The overall rate of AL was 9.9 %. Low preoperative serum albumin and emergency procedure had statistically significant association. The mean hospital stay was 12 days. Anastomotic leak-associated death rate was 48%.
Conclusion: In this study, most patients had elective surgeries involving the colon. Most of them developed enteroenteric ALs with longer hospital stays, and higher death rates, affirming that AL significantly increases morbidity, mortality and cost.
