Abstract Background Ileostomy creation is a common procedure in patients with chronic inflammatory bowel disease and colorectal cancer. One of the most common complications after discharge is dehydration, often related to the stoma’s high output, which can lead to electrolyte imbalances and an increased risk of renal failure and hospital readmission. To identify patients most at risk early, Chen et al. developed the DRIP score in 2018 1. This score integrates several clinical factors to predict readmission for dehydration in patients undergoing ileostomy creation. In particular, the presence of inflammatory bowel disease and of an ileoanal-pouch anastomosis were two of these items. Thus, we wanted to assess the accuracy of the DRIP score in a real-world setting. Methods This study is a prospective observational study evaluating the accuracy of the DRIP score in predicting variation of serum creatinine of at least 10 mmol/l at the 5th postoperative day (T1) compared to the preoperative values (T0) and acute renal failure events at one month after surgery (T2). We enrolled 32 consecutive patients admitted for major colonic resection and ileostomy creation for ulcerative colitis (UC), Crohn’s disease (CD) and rectal cancer. ROC curves analysis and non-parametric statistics were performed. Results We enrolled 15 UC patients undergoing restorative proctocolectomy, 4 CD patients undergoing colectomy, and 13 rectal cancer patients undergoing low anterior resection. The analysis revealed no significant differences between the IBD and cancer patients in terms of age, BMI, creatinine levels, and DRIP score. This suggests that the risk of dehydration is not dependent on the underlying condition, but rather on individual clinical characteristics. The ROC curve showed a good ability of the DRIP score to predict an early increase in creatinine levels in the immediate postoperative period, indicating a potential risk of renal impairment (Fig. 1A). However, one month after surgery, it failed to identify patients with deteriorating renal function (Fig. 1B). Conclusion In conclusions, the DRIP score is useful for early identification of at-risk patients during hospitalization but it is limited in predicting long-term renal function, since it cannot consider interventions implemented to combat dehydration. This study highlights the usefulness of the DRIP score in clinical practice and confirms the central role of nurses in preventing dehydration through monitoring, education, and patient support after discharge. Reference: 1. Chen SY, Stem M, Cerullo M, Canner JK, Gearhart SL, Safar B, Fang SH, Efron JE. Predicting the Risk of Readmission From Dehydration After Ileostomy Formation: The Dehydration Readmission After Ileostomy Prediction Score. Dis Colon Rectum. 2018 Dec;61(12):1410-1417. doi: 10.1097/DCR.0000000000001217. Conflict of interest: Vianello, Chiara: No conflict of interest Matteazzi, Anna: No conflict of interest Rocchi, Silvia: No conflict of interest Angriman, Imerio: No conflict of interest Saadeh, Luca: No conflict of interest Ruffolo, Cesare: No conflict of interest Rollo, Elena: No conflict of interest Giorato, Edoardo: No conflict of interest Zamprogno, Mattia: No conflict of interest Pizzarelli, Francesco: No conflict of interest Spolverato, Gaya: No conflict of interest Barbierato, Maria: No conflict of interest Dr. Scarpa, Marco: No conflict of interest
Vianello et al. (Thu,) studied this question.