AimApproximately 4000 patients in the UK have an emergency intestinal stoma formed each year. Stoma‐related complications (SRCs) are heterogeneous but have previously been subcategorized into early or late SRCs, with early SRCs generally occurring within 30 days postoperatively. Early SRCs include skin excoriation, stoma necrosis and high output, while late SRCs include parastomal hernia, retraction and prolapse. There is a paucity of research on specific risk factors within the emergency cohort for development of SRCs. This paper aims to describe the incidence of SRCs after emergency intestinal surgery and to identify potential risk factors for SRCs within this cohort.MethodConsecutive patients undergoing emergency formation of an intestinal stoma (colostomy, ileostomy or jejunostomy) were identified prospectively from across three acute hospital sites over a 3‐year period from the ELLSA (Emergency Laparotomy and Laparoscopic Scottish Audit) database. All patients were followed up for a minimum of 1 year. A multivariate logistic regression model was used to identify risk factors for early and late SRCs.ResultsA total of 455 patients were included (median follow‐up 19 months, median age 64 years, male:female 0.52, 56.7% ileostomies). Early SRCs were experienced by 54.1% of patients, while 51% experienced late SRCs. A total of 219 patients (48.1%) had their stoma sited preoperatively. Risk factors for early SRCs included end ileostomy formation [OR 3.51 (2.24–5.49), p < 0.001], while preoperative stoma siting was found to be protective [OR 0.53 (0.35–0.83), p = 0.005]. Patient obesity [OR 3.11 (1.92–5.03), p < 0.001] and reoperation for complications following elective surgery [OR 4.18 (2.01–8.69), p < 0.001] were risk factors for late SRCs.ConclusionStoma‐related complications after emergency surgery are common. Preoperative stoma siting is the only truly modifiable risk factor to reduce SRCs, and further research should be aimed at methods of improving the frequency and accuracy of this in the emergency setting.

中文翻译：

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紧急肠造口手术后的术后结果和并发症危险因素的识别——一项多中心回顾性研究

目标英国每年约有 4000 名患者进行紧急肠造口。造口相关并发症 (SRC) 多种多样，但之前已被分为早期或晚期 SRC，早期 SRC 通常发生在术后 30 天内。早期SRC包括皮肤脱落、造口坏死和高输出，而晚期SRC包括造口旁疝、回缩和脱垂。对于 SRC 发展的紧急队列中的特定风险因素的研究很少。本文旨在描述紧急肠道手术后 SRC 的发生率，并确定该队列中 SRC 的潜在危险因素。方法前瞻性地从三个急症医院地点连续进行紧急肠造口形成（结肠造口、回肠造口或空肠造口）的患者进行识别来自 ELLSA（紧急剖腹手术和腹腔镜苏格兰审计）数据库的 3 年多的数据。所有患者均接受至少 1 年的随访。采用多变量逻辑回归模型来识别早期和晚期 SRC 的危险因素。 结果 总共纳入 455 名患者（中位随访时间 19 个月，中位年龄 64 岁，男性：女性 0.52，回肠造口率 56.7%）。 54.1% 的患者经历过早期 SRC，而 51% 的患者经历过晚期 SRC。共有 219 名患者（48.1%）在术前进行了造口定位。早期 SRC 的危险因素包括末端回肠造口形成 [OR 3.51 (2.24–5.49)，p< 0.001]，而术前造口选址具有保护作用 [OR 0.53 (0.35–0.83)，p= 0.005]。患者肥胖 [OR 3.11 (1.92–5.03),p< 0.001] 和择期手术后并发症再次手术 [OR 4.18 (2.01–8.69)，p< 0.001] 是晚期 SRC 的危险因素。结论 急诊手术后造口相关并发症很常见。术前造口选址是减少 SRC 的唯一真正可改变的风险因素，应进一步研究在紧急情况下提高造口频率和准确性的方法。