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Risk Factors of Brenner et al for Recurrence of an Enterocutaneous Fistula (ECF) Following Surgical Repair

Description

Brenner et al identified risk factors for recurrence of an enterocutaneous fistula (ECF) following surgical repair. Recurrence of a fistula is the primary determinant of mortality for patients with an ECF. The authors are from the University of California at Los Angeles.


 

Patient selection: surgical repair of an enterocutaneous fistula

 

Parameters:

(1) underlying disease

(2) number of weeks between diagnosis of ECF and initial surgical repair

(3) location of the involved bowel

(4) method of anastomosis

 

Parameter

Finding

Points

underlying disease

other than Crohn's disease

0

 

Crohn's disease

1

number of weeks

< 36 weeks

0

 

>= 36 weeks

1

involved bowel

large intestine

0

 

small intestine

1

method of anastomosis

non-stapled

0

 

stapled

1

 

number of risk factors for recurrence of the fistula =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 4

• The risk of recurrence increases as the number of risk factors increase.

• The odds ratio are 4.9, 5.4, 9.8 and 4.1 respectively. One modification is to assign 2 points to small bowel involvement.

 


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