Predictors of mortality and major complications after colostomy reversal: An analysis of national surgical quality improvement program database

Am J Surg. 2025 Nov 7;252:116713. doi: 10.1016/j.amjsurg.2025.116713. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to determine the predictors of post-operative complications and mortality for patients undergoing colostomy reversal using the National Surgical Quality Improvement Program database.

METHODS: We included patients>18 undergoing elective colostomy reversal. A multivariate analysis was performed to find independent predictors of 30-day major complications and death following a colostomy reversal.

RESULTS: Independent predictors of a major complication were age>70 (odds ratio (OR):1.24), having a body mass index≥40 ​kg/m²(OR:1.42), smoking(OR:1.24), history of severe chronic obstructive pulmonary disease(OR:1.96), having a dependent or partially dependent functional status(OR:1.48), hypertension(OR:1.25), steroid use(OR:1.38), being on dialysis(OR:2.37), and bleeding disorder(OR:1.60). When compared with laparoscopic reversal, the open approach was an independent predictor of both major complications (OR:1.67) and death (OR 3.42).

CONCLUSIONS: Age, BMI, smoking, functional status, and some comorbidities can predict higher-risk patients for colostomy reversal. Identifying high-risk patients for elective colostomy reversal may help guide preoperative counseling and risk mitigation strategies.

PMID:41273990 | DOI:10.1016/j.amjsurg.2025.116713