Humayun Riaz-ud Din Haider, Masood Ahmed, Shehzad Bashir, Abdul Rehman Alvi, Zumra Mahmood, Muhammad Kamal Subhani, Mujahid Hussain.
Bowel anastomosis: adverse outcome and health expenditures in two age groups.
Pak J Med Health Sci Jan ;13(4):855-8.

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 201 8 - 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 seen anastomosis in open surgery . On 4 thday 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.

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