CLINICAL STUDY OF FACTORS PREDICTING MORTALITY IN ENTEROCUTANEOUS FISTULAS

Abstract

Introduction: Enterocutaneous stulas pose a great challenge to General surgeons as well as Gastrosurgeons. About 75%–85% of enterocutaneous stulas are iatrogenic in origin. Reported mortality rates range from 6%–33%. Knowing the factors contributing to mortality in ECF would help overcome the burden. This is Materials and Methods: a retrospective study of 42 enterocutaneous stula patients treated at Department of General Surgery, Government General Hospital, Kakinada over a span of 4 years from June 2018- June 2022. Out of 42 cases, 16 have expired. The most common primary etiology was Results: malignancy and the highest association with mortality was noted with mesenteric ischemia. ECF from large bowel had higher mortality. Sepsis(p value – 0.02) was associated with higher mortality. High output stulas had higher mortality. Hypoalbuminemia(p value – 0.02), associated Acute Kidney Injury (p value <0.0001), those on TPN(p value – 0.02) and those surgically managed(p value – 0.0003) were signicantly contributing to mortality. Despite many Conclusion: advances, enterocutaneous stulas still contribute to a signicant mortality rate. Control of sepsis, building the nutrition and correction of electrolyte abnormalities should be focused upon as they can improve the outcome in these patients.