Retrospective analysis of factors associated with emergency colostomy: an institutional experience

Abstract

<p class="abstract"><strong>Background:</strong> Colostomy is one of the commonest lifesaving procedures done worldwide with an intention of either decompression of an obstructed colon or diversion of stool. This study tries to assess the pattern of emergency colostomy and factors associated with its complication in adult patients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.</p><p class="abstract"><strong>Methods:</strong> Retrospective reviews of charts were done of all adult patients who underwent colostomy procedure from December 1, 2016 to May 30, 2019. </p><p class="abstract"><strong>Results:</strong> There were 149 adult patients that underwent colostomy procedure in the study period and the majorities were male (83.2%). Majority of the procedures were done for indication of LBO secondary gangrenous sigmoid volvulus (49%). The most common comorbidity identified were renal disease (5%) and diabetes mellitus (3%). All patients who presented with gangrenous sigmoid volvulus underwent end colostomy procedure and 16.8% of them died. Generally, 69 patients among 149 (46.3%) developed certain type of complication. Presence of complication was significantly associated with increased chance of death by eight times than those who had no complication after the procedure. End colostomy was significantly associated with development of complication when compared to loop colostomy. Among the study participants 87.9% of them were discharged improved. The main cause of death was multi organ failure secondary to septic shock, which accounted to 52.9% of all deaths.</p><p class="abstract"><strong>Conclusions:</strong> Gangrenous sigmoid volvulus, colorectal cancer and trauma were leading indications for colostomy. Presence of complication and type of colostomy were factors significantly associated with outcome.</p>