Factors Associated with Stoma Formation in Ileocolic Resection for Crohn's Disease and the Development of a Predictive Scoring System

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2022 Jul 29

PMID 35906298

Authors

Dakshitha Wickramasinghe

Michele Carvello

Francesca Di Candido

Annalisa Maroli

Samuel Adegbola

Kapil Sahnan

Pritesh Morar

Antonino Spinelli

Janindra Warusavitarne

Affiliations

Soon will be listed here.

Abstract

Purpose: The likelihood of a stoma following ileocolic resection (ICR) for Crohn's disease (CD) is an important consideration. This study aims to identify the factors associated with an increased likelihood of a stoma and develop a predictive scoring system (SS).

Methods: Patient data were collected from St. Marks Hospital, London, UK and Humanitas Clinical and Research Center, Milan, Italy, on all patients who underwent an ICR for CD from 2005 to 2017. A logistic regression analysis was used for multivariate analysis. The SS was developed from the logistic regression model. The performance of the SS was evaluated using receiver operating characteristics area under the curve (AUROC).

Results: A total of 628 surgeries were included in the analysis. Sixty-nine surgeries were excluded due to missing data. The remaining 559 were divided into two cohorts for the scoring system's development (n = 434) and validation (n = 125). The regression model was statistically significant (p < 0.0001). The statistically significant independent variables included sex, preoperative albumin and haemoglobin levels, surgical access and simultaneous colonic resection. The AUROC for the development and validation cohorts were 0.803 and 0.905, respectively (p < 0.0001). Youden's index suggested the cut-off score of - 95.9, with a sensitivity of 87.6% and a specificity of 62.9%.

Conclusions: Male sex, low preoperative albumin, anaemia, laparoscopic conversion and simultaneous colonic resection were associated with an increased likelihood of requiring a stoma and were used to develop an SS. The calculator is available online at https://rebrand.ly/CrohnsStoma .

Citing Articles

Machine learning for temporary stoma after intestinal resection in surgical decision-making of Crohn's disease.

Wang F, Lin Y, Gao R, Wu X, Wu T, Jiao Y BMC Gastroenterol. 2025; 25(1):117.

PMID: 40000985 PMC: 11863836. DOI: 10.1186/s12876-025-03668-7.

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