Clinical anastomosis leakage and determinant factors among patients who had intestinal anastomosis in two Ethiopian tertiary hospitals
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Introduction : Intestinal anastomosis is a common surgical procedure, but anastomotic leaks remain significant postoperative complications, causing morbidity, prolonged hospital stays, and readmissions. This study aimed to identify the rate, determinant factors, and outcomes associated with anastomotic leakage for patients undergo gastrointestinal anastomoses in two major hospitals in Addis Ababa, Ethiopia. Method: A retrospective cross-sectional study used and 206 patients who underwent bowel anastomosis between 2016 and 2019 GC. To asses Determinant factor first bivariate analysis was done for all independent variables and for variables with P. value < 0.2 multiple logistic regresion was performed to identify independent predictors of anastomotic leakage. Odds ratios were computed, and a p-value <0.05 was considered statistically significant and Hosmer-Lemeshow goodness-of-fit test was run to ascertain the fitness of the model Results: The clinical anastomotic leak (AL) rate in this study was 8.3%. The presence of gangrenous bowel at the time of surgery was a strong independent predictor of AL (AOR 4.88; 95% CI: 1.62–14.69; p < 0.001). Intraoperative blood loss greater than 500 mL was also significantly associated with an increased risk of leakage (AOR 3.13; 95% CI: 1.07–9.17; p = 0.029). Moreover, patients who developed anastomotic leakage had a higher risk of mortality (AOR 5.495; 95% CI: 1.517–20.00; p = 0.004). The presence of AL was additionally associated with prolonged hospital stay beyond 20 days (AOR 5.49; 95% CI: 1.99–7.12; p = 0.000). 3.13; (1.07–9.17) Conclusion: In this study, anastomotic leakage was found to be higher than expected. Bowel viability and the amount of blood loss were significant predictors of clinical anastomotic leakage. Additionally, the presence of anastomotic leakage was associated with increased mortality and prolonged hospitalization.
