Prognostic factors in the decision-making process for sigmoid volvulus: results of a single-centre retrospective cohort study

Abstract

Background: Sigmoid volvulus is a common cause of emergency surgical admission. Those patients are often treated conservatively with a high rate of recurrence. We wondered if a more aggressive management might be indicated.

Methods: We have reviewed data of patients diagnosed with acute sigmoid volvulus over a 2-year period. The primary endpoint was patient survival.

Results: We analysed 332 admissions of 78 patients. 39.7% underwent resection. Survival was 54.9 ± 8.8 months from the first hospitalization, irrespective of the treatment. Long-term survival was positively influenced by being female, having a low "social score", a younger age and surgery. Multivariate analysis showed that only being female and surgery were independently associated with better survival.

Conclusion: Early surgery may be the best approach in patients with recurrent sigmoid volvulus, as it ensures longer survival with a better quality of life, regardless of the patient's social and functional condition.

Keywords: Emergency colon resection; Frailty; Sigmoid volvulus.

Fig. 1

Proportional hazard to undergo surgery

Fig. 2

Survival according to treatment (early surgery vs late surgery vs no surgery) (p < 0.001)

Fig. 3

Survival according to Social Score (p < 0.01) (for definition of Social Score see text)

Fig. 4

Survival according to age (> or < 80) (p < 0.003)

Fig. 5

Survival according to gender (p < 0.005)