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Patients With Temporary Ostomies: Veterans Administration Hospitals Multi-institutional Retrospective Study

Mohammed Ilyas, Mohammed Iyoob; Haggstrom, David A.; Maggard-Gibbons, Melinda A.; Wendel, Christopher S.; Rawl, Susan; Schmidt, Christian Max; Ko, Clifford Y.; Krouse, Robert S.

Journal of Wound Ostomy & Continence Nursing: November/December 2018 - Volume 45 - Issue 6 - p 510–515
doi: 10.1097/WON.0000000000000478
Ostomy Care

PURPOSE: The purpose of this study was to describe clinical outcomes of patients with temporary ostomies in 3 Veterans Health Administration hospitals.

DESIGN: Retrospective descriptive study, secondary analysis.

SAMPLE AND SETTING: Veterans with temporary ostomies from 3 Veterans Health Administration hospitals who were enrolled in a previous study. The sample comprised 36 participants all were male. Their mean age was 67.05 ± 9.8 years (mean ± standard deviation). Twenty patients (55.6%) had ileostomies and 16 patients (44.4%) had colostomies.

METHODS: This was a secondary analysis of data collected using medical record data. Variables examined included etiology for creation and type of ostomy, health-related quality of life, time to reversal, reasons for nonreversal, postoperative complications after reversal, and mortality in the follow-up period.

RESULTS: Colorectal cancer and diverticular disease were the main reasons for temporary stoma formation. The reversal rate was 50%; the median time to reversal was 9 months in our sample; temporary ileostomies were reversed more often than temporary colostomies (P = .18). Comorbid conditions were identified as the main reason for nonreversal. Mortality was not significantly different between the reversal and nonreversal groups. No significant differences were reported with health-related quality-of-life parameters between reversal and nonreversal groups.

CONCLUSIONS: This study identified that the proportion of temporary ostomies was limited to 50%. Complications during the index operation, medical comorbidities, and progression of cancer are the main reasons for nonreversal of temporary stomas. Study findings should be included in the counseling of patients who are likely to get intestinal stomas with temporary intention, and during consideration for later reversal of a stoma.

The CE test for this article is available online only at the journal website, jwocnonline.com, and the test can be taken online at NursingCenter.com/CE/JWOCN.

Mohammed Iyoob Mohammed Ilyas, MBBS, MS, MRCS, University of Arizona College of Medicine, Tucson, and Southern Arizona Veterans Affairs Health Care System, Tucson.

David A. Haggstrom, MD, Richard L. Roudebush Veterans Affairs Medical Center, and Indiana University School of Medicine, Indianapolis.

Melinda A. Maggard-Gibbons, MD, MSHS, Veterans Affairs Greater Los Angeles Health Care System, Los Angeles, California.

Christopher S. Wendel, MS, University of Arizona College of Medicine, Tucson, and Southern Arizona Veterans Affairs Health Care System, Tucson.

Susan Rawl, PhD, RN, Indiana University School of Nursing, Indianapolis.

Christian Max Schmidt, MD, PhD, MBA, Richard L. Roudebush Veterans Affairs Medical Center, and Indiana University School of Medicine, Indianapolis.

Clifford Y. Ko, MD, UCLA School of Medicine, Los Angeles, California.

Robert S. Krouse, MD, Corporal Michael J. Crescenz Veterans Affairs Medical Center, and University of Pennsylvania Department of Surgery, and Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania.

Correspondence: Robert S. Krouse, MD, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Surgical Service (112), 3900 Woodland Ave, Philadelphia, PA 19104 (robert.krouse@va.gov).

This work was supported by the Veterans Affairs Health Services Research and Development Service (Merit Award IIR-02-221). The funder had no role in study design, collection, analysis and interpretation of data, writing of this report, or in the decision to submit the article for publication.

The authors declare no conflicts of interest.

© 2018 by the Wound, Ostomy and Continence Nurses Society.