Bowel anastomosis: Adverse outcome and health expenditures in two age groups

Background: Risk of bowel problems e.g. colorectal cancer increments with increase in age. Same patterns can be seen on post intestinal anastomotic adverse outcomes and associated health expenditures(by families). Aim: To compare the post bowel anastomosis complications and incurred fiscal costs in two age groups Place and duration: Surgical Unit 2, DHQ Hospital, Gujranwala; July 2018 - June 2019 Methodology: Sixty six consecutive emergency patients (aged ≥41 years) with bowel problems were registered before group A (41-60) or B (≥61 years of age) allocation. The bowel resection was followed by stapler sewn anastomosis in open surgery. On 4thday of surgery, patients were assessed for anastomotic failure, deep organ infection, or redo surgery. Results: One death and two follow up losing cases left 63 patients for data analysis. The population was male dominated (N = 45, 71.4%) with two age groups i.e. A (M = 43) and B (M = 64 years). The rate of bowel necrosis ranked 1st(n = 16).Post-anastomotic complications appeared in overall nine (14.3%) patients. A subject of group B had approximately 4 time more likelihood of the complications (OR = 3.91; 95%CI:.896-24.8460, p = .05) than subjects of other group. The families of seven patients in group B spent Pak Rs. 221, 520 on complication management. Conclusion: Post bowel anastomosis complications and associated health expenditures are higher in ≥60 than 41-60 years old individuals.