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Factors associated with emergent colectomy in patients with neutropenic enterocolitis

  • Omar Vergara-Fernández
  • Mario Trejo-AvilaEmail author
  • Danilo Solórzano-Vicuña
  • Oscar Santes
  • Noel Salgado-Nesme
Original Article
  • 22 Downloads

Abstract

Purpose

Neutropenic enterocolitis (NEC) is a severe complication of neutropenia. NEC is characterized by segmental ulceration, intramural inflammation, and necrosis. Factors present in patients who underwent colectomy have never been studied. The present study aimed to describe the clinical factors present in patients who underwent emergent colectomy for the treatment of neutropenic enterocolitis.

Methods

Patients admitted with neutropenic enterocolitis from November 2009 to May 2018 were retrospectively analyzed. Logistic regression analysis was used to determine clinical factors associated with emergent colectomy.

Results

Thirty-nine patients with NEC were identified. All patients had a hematological disorder. Medical treatment was the only management in 30 (76.9%) patients, and 9 (23.1%) patients underwent colectomy. No differences were found between the treatment groups regarding sex, age, or comorbidities. Patients were more likely to undergo colectomy if they developed abdominal distention (OR = 12, p = 0.027), hemodynamic failure (OR = 6, p = 0.042), respiratory failure (OR = 17.5, p = 0.002), multi-organic failure (OR = 9.6, p = 0.012), and if they required ICU admission (OR = 11.5, p = 0.007). Respiratory failure was the only independent risk factor for colectomy in multivariable analysis. In-hospital mortality for the medical and surgical treatment groups was 13.3% (n = 4) and 44.4% (n = 4), respectively (p = 0.043).

Conclusions

In our study, most NEC patients were treated conservatively. Patients were more likely to undergo colectomy if they developed organ failures or required ICU admission. Early surgical consultation is suggested in all patients with NEC.

Keywords

Neutropenic enterocolitis Typhlitis Febrile neutropenia Colectomy 

Notes

Authors’ contributions

Omar Vergara-Fernández and Mario Trejo-Avila designed this work, collected and interpreted the data, and drafted the manuscript. Omar Vergara-Fernández, Mario Trejo-Avila, Danilo Solórzano-Vicuña, Oscar Santes, and Noel Salgado-Nesme interpreted data, critically revised the manuscript, and performed overall supervision. All authors contributed to the final approval of the manuscript.

Funding information

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

Informed consent was waived owing to the retrospective nature of the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryInstituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Mexico CityMexico

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