Determination of independent predictive factors for anastomotic leak: analysis of 682 intestinal anastomoses

BACKGROUND: The objective of this study was to identify risk factors associated with intestinal anastomotic leakage in order to practically assist in surgical decision making. METHODS: A retrospective review of an academic surgery database was performed over 5 years to identify patients who had intestinal (small bowel and colon) anastomoses to determine independent predictors of anastomotic leakage. RESULTS: Over the study period, 682 patients were identified with intestinal anastomoses; the overall leak rate was 5.6% (38/682). In bivariate analysis, 9 factors were associated with anastomotic leaks. Of these, 3 were found to be independent predictors of anastomotic leakage using a logistic regression model: anastomotic tension (odds ratio [OR] = 10.1, 95% Confidence Interval [CI] 1.3 to 76.9), use of drains (OR = 8.9, 95% CI 4.3 to 18.4), and perioperative blood transfusion (OR = 4.2, 95% CI 1.4 to 12.3). CONCLUSIONS: The recognition of factors associated with anastomotic leakage after intestinal operations can assist surgeons in mitigating these risks in the perioperative period and guide intraoperative decisions. (C) 2013 Elsevier Inc. All rights reserved.