Clinical anastomosis leakage and associated factors among patients in Ethiopia

What is it about?

Background: Anastomotic leakage leads to increased hospital costs, lengths of stay, readmissions, reoperations and death. Therefore, this study aimed to assess clinical anastomotic leakage and associated factors among patients who had intestinal anastomosis in Northwest Amhara regional State referral Hospitals, Ethiopia, 2020. Method: A retrospective cross-sectional study design was conducted among 411 randomly selected patients. The patient’s medical records included for this study were intestinal anastomosis, which was performed from February 2017 to February 2020. The date range during which patients’ medical records were extracted was from March 1 to June 2020. Patient medical record charts and data extraction sheet were used to collect the data. Data was entered into EPI - DATA version 3.1 and exported into SPSS version 24 for analysis. Binary and multiple logistic regression analysis was used to assess the association between dependent and independent variables. P-value of less than 0.05 and odds ratio with 95% CI were used to declare the presence of association. Results: The response rate of the study was 99.8%. Of 411 patients, 38 patients developed clinical anastomotic leakage, which makes the prevalence rate 9.2%. Age group 0-10 years (AOR=6.85 95% CI: 1.742-26.97), emergency presentation (AOR=3.196 95% CI: 1.132-9.025), and pre-operative comorbid disease (AOR =7.62 95% CI: 2.804-20.68) were significantly associated with anastomotic leak. Conclusions: Clinical anastomotic leakage is higher than the expected rate (4.9%-7.2%). Age, emergency presentation, and comorbidities were associated to clinical anastomotic leak. Hence, attention to early identification of risk factors and providing optimal pre-operative, operative and post-operative care is necessary.

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Photo by National Cancer Institute on Unsplash

Photo by National Cancer Institute on Unsplash

Why is it important?

The finding of this research will be input to health care providers, program managers and policy makers for designing, proper implementation and evaluation of programs on reduction of adverse surgical outcomes and improvement of patient care. Furthermore, the findings will create awareness in the hospital about the problem and contribute towards formulating appropriate interventions to prevent leakage rate and it will be used as a resource for governmental and non-governmental organizations which work on this issue.