1. Colectomy and the Incidence of Postsurgical Complications Among Ulcerative Colitis Patients With Private Health Insurance in the United States.
- Author
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Loftus, Jr, Edward V., Delgado, David J., Friedman, Howard S., and Sandborn, William J.
- Subjects
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COLECTOMY , *ULCERATIVE colitis , *HEALTH insurance , *COLON surgery - Abstract
PURPOSE: We sought to describe the types of colectomy, follow-up surgical/diagnostic procedures, and complications occurring within 180 days of colectomy in a population of privately insured individuals with ulcerative colitis (UC). METHODS: This was a retrospective analysis of claims data of privately insured patients (MarketScan) for the years 2001–2004. We identified a cohort of patients with UC who underwent colectomy. Colectomies were classified into four categories based on the surgery occurring on the first colectomy date: (a) total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA), (b) subtotal colectomy (SC) with ileostomy and Hartmann pouch or ileorectal anastomosis, (c) TPC with ileostomy, and (d) partial colectomy (PC). Follow-up surgical/diagnostic procedures and complications were compared across colectomy categories. RESULTS: A total of 25,586 UC patients were identified, of whom 215 patients had a colectomy and at least 180 days of pre- and postcolectomy follow-up. The colectomy distribution was: TPC-IPAA (52%), SC-ileostomy (22%), TPC-ileostomy (14%), and PC (13%). Within 180 days postcolectomy, 54% of patients had a second colectomy-related surgery (including unplanned surgeries in 15.3%), and 27% had a follow-up diagnostic procedure. Postcolectomy complications included abscesses (11.6% in the first 30 days postcolectomy, 16.3% in the day 31–180 postcolectomy period), fistulas (4.2% early, 6.0% late), and sepsis/pneumonia/bacteremia (7.9% early, 9.3% late). CONCLUSION: Postcolectomy surgical procedures and complications occur frequently after colectomy in privately insured patients with UC. [ABSTRACT FROM AUTHOR]
- Published
- 2008
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