Abdominal Emergency Surgery in Inflammatory Bowel Disease: Postoperative Outcomes and Risk Factors for Adverse Events and Prolonged Hospitalization

Despite the advances in the pharmacological treatment of inflammatory bowel disease (IBD), the rate of surgical interventions remains high. These are typically associated with a high morbidity. The aims of the study were to assess the postoperative complications of emergency surgery in patients with IBD and to describe factors that may affect its occurrence. A case series analysis of consecutive patients who underwent emergency surgery due to inflammatory bowel disease from December 1991 and December 2020 was conducted. Sixty-five patients were included. The most common cause of surgery was intestinal perforation, and total colectomy was the most common procedure. Morbidity events occurred in 41 patients; twenty-six patients required staying in the intensive care unit, and the median length of stay was 20 days. Multivariate analysis identified the use of intraoperative vasopressors as a risk factor for perioperative morbidity, for length of stay (LOS) ≥ 14 days, and for postoperative mortality. The ROC analysis showed an intraoperative blood loss ≥ 275 mL with a sensitivity of 78.38% and specificity of 52.17% for LOS > 14 days and a platelet to lymphocyte ratio ≥ 289.93 with a sensitivity of 70.59% and specificity of 60.87% for the same outcome. Emergency surgery in IBD has a significant morbidity rate. Intraoperative vasopressor use was found as a risk factor for the development of morbid events, prolonged LOS, and postoperative mortality. Age and intraoperative blood loss, as well as the platelet to lymphocyte ratio, serve as significant categorical predictors for postoperative outcomes.