The clinical characteristics and prognostic risk factors of duodenal lateral wall fistula Article Swipe
YOU?
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· 2024
· Open Access
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· DOI: https://doi.org/10.4103/wjsi.wjsi_10_24
· OA: W4407025549
Objective: This study aimed to examine the clinical characteristics, prognosis, and high-risk factors affecting the outcomes of duodenal lateral wall fistulas, with the goal of improving treatment strategies. Methods: A retrospective analysis was conducted using data from the China Intestinal Fistula and Intra-abdominal Infection Registry System, including 142 patients hospitalized with duodenal lateral wall fistula between January 1 and December 31, 2018. Results: The primary diagnoses included gastrointestinal ulcers/perforations, biliary diseases, and trauma, with 82.4% of patients presenting a single fistula and 17.6% having fistulas in other locations. The overall mortality rate was 10.6%, and 89.4% of patients achieved recovery through either conservative or surgical treatment. Multivariate logistic regression analysis identified age ≥60 years (odd ratio [OR] = 44.375, 95% confidence interval [CI]: 2.676–735.822), presence of fistulas in additional locations (OR = 16.54, 95% CI: 1.744–156.913), and multiple organ dysfunction syndrome (MODS) (OR = 238.447, 95% CI: 9.496– 5987.78) as independent risk factors for mortality. Conclusions: Findings indicate that advanced age, fistula location, and MODS are critical determinants of prognosis in duodenal lateral wall fistula patients, underscoring the need for focused management in these high-risk groups.
