Original article—alimentary tractPostoperative Complications and Mortality Following Colectomy for Ulcerative Colitis
Section snippets
Patient Data Source
The Data Integration, Measurement and Reporting hospital discharge abstract administrative database captures all hospitalizations in the Calgary Health Zone of Alberta Health Services, Canada. The Calgary Health Zone is a population-based health authority under a public, single-payer system and provides all levels of medical and surgical care to the residents of the city of Calgary and more than 20 nearby smaller cities. The estimated population of the Calgary Health Zone in 2008 was 1,275,664.8
Results
Between January 1, 1996, and December 31, 2009, we identified 666 patients with UC who underwent a colectomy. The surgeries performed included colectomy with the following: (1) a 1-stage ileal pouch anal anastomosis (3.5%); (2) pouch formation with temporary ileostomy (59.2%); (3) temporary ileostomy without pouch formation (33.5%); and (4) permanent ileostomy (3.8%). The characteristics of patients with UC, stratified by postoperative complications, are presented in Table 1. Many UC patients
Discussion
This study identified a population-based cohort of 666 UC patients who underwent a colectomy within a 14-year period. The entire population was assessed rather than restricted to a subset that would be subjected to referral bias, such as patients undergoing surgery only in a tertiary center. We confirmed the diagnosis, surgery, and postoperative complications through medical chart review, which minimized misclassification errors that commonly occur in studies using an administrative database.
Acknowledgments
The authors acknowledge the Data Integration, Measurement and Reporting Department for providing data from the Calgary Health Zone.
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Conflicts of interest These authors disclose the following: Remo Panaccione has served as a speaker, a consultant, and an advisory board member for Abbott Laboratories, Merck, Schering-Plough, Shire, Centocor, Elan Pharmaceuticals, and Procter and Gamble; as a consultant and speaker for Astra Zeneca; as a consultant and an advisory board member for Ferring and UCB; as a consultant for Glaxo-Smith Kline and Bristol Meyers Squibb; as a speaker for Byk Solvay, Axcan, Jansen, and Prometheus; has received research funding from Merck, Schering-Plough, Abbott Laboratories, Elan Pharmaceuticals, Procter and Gamble, Bristol Meyers Squibb, and Millennium Pharmaceuticals; and has received educational support from Merck, Schering-Plough, Ferring, Axcan, and Jansen. Subrata Ghosh has served as a speaker for Merck, Schering-Plough, Centocor, Abbott, UCB Pharma, Pfizer, Ferring, and Procter and Gamble; has participated in ad hoc advisory board meetings for Centocor, Abbott, Merck, Schering-Plough, Proctor and Gamble, Shire, UCB Pharma, Pfizer, and Millennium; and has received research funding from Procter and Gamble, Merck, and Schering-Plough. Gilaad Kaplan has served as an advisory board member for Abbott, UCB, Shire, Merck, and Schering-Plough; has served as a speaker for Merck, Schering-Plough, UCB, and Abbott; and is supported through a New Investigator Award from the Canadian Institute of Health Research and a Population Health Investigator Award from the Alberta Heritage Foundation for Medical Research. Shania de Silva was an Advanced Inflammatory Bowel Disease Fellow at the University of Calgary. Christopher Ma was supported by a summer studentship award from the Alberta Heritage Foundation for Medical Research. Martin Prusinkiewicz was supported by an American Gastroenterological Association Foundation Student Research Fellowship Award. The remaining authors disclose no conflicts.
Funding Supported by the M.S.I. Foundation and supported in part by the Alberta IBD Consortium, which is funded by an Alberta Heritage Foundation for Medical Research (AHFMR) Interdisciplinary Team Grant (AHFMR is now Alberta Innovates Health Solutions).