Predicting the risk of dehydration and readmission among rectal cancer patients with ileostomy: a multicenter observational study

Dehydration is a frequent complication among rectal cancer patients after ileostomy, often resulting in hospital readmission. The Dehydration Readmission after Ileostomy Prediction (DRIP) score was used to identify patients at risk of dehydration-related readmission. The aim of this study is to assess the predictive value of the DRIP score for dehydration-electrolyte imbalance (DIE) and hospital readmission in a multicenter Italian cohort. A total of 306 patients with rectal adenocarcinoma who underwent anterior resection with protective ileostomy in 2022 were included. The main outcome measures were the incidence of early and late DIE, hospital readmission due to DIE, and correlations between the DRIP score and other clinical variables. Early DIE occurred in 16.3% of the patients, with 2.6% requiring readmission. Late DIE occurred in 13.7% of the patients, with 3.6% requiring readmission. The DRIP score was significantly correlated with early DIE. A high DRIP score was associated with an increased risk of early and late DIE. Independent predictors of early DIE included high BMI and early postoperative complications. Parastomal infection was the only independent predictor of late readmission. The DRIP score represents a useful tool for identifying patients at risk of early dehydration following ileostomy. While its ability to predict hospital readmission is limited, it provides clinically relevant risk stratification for early DIE and may support targeted postoperative monitoring strategies. Future studies should integrate dynamic patient-specific data to increase the predictive accuracy of the score and guide both inpatient and outpatient care.

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Journal
Updates in Surgery
Published
2026-09-07
DOI
https://doi.org/10.1007/s13304-026-02709-4
Primary Topic
Stoma care and complications
Type
article
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article

Predicting the risk of dehydration and readmission among rectal cancer patients with ileostomy: a multicenter observational study

Luigi Boccia, Alessandro Cannavera, Raffaele Galleano, A Vitali et al.
Updates in Surgery
Stoma care and complications
article

Predicting the risk of dehydration and readmission among rectal cancer patients with ileostomy: a multicenter observational study

Luigi Boccia, Alessandro Cannavera, Raffaele Galleano, A Vitali, Marco Veltri, Michele Benedetti, Michele Manigrasso, Antonello Deserra, Alessandro Anastasi, Fabio Porcelli, Francesco Denti, Cristiana Forni, Marco Palisi, Fabrizio Scognamillo, Marta Spalluto, Annalisa Pascariello, Sabrina Pedon, Francesco Bagolini, Gianluigi Moretto, Alberto Brun Peressut, Raffaele De Luca, Ugo Grossi, Chiara Marafante, G. Mantovani, Marco Catarci, Andrea Bondurri, Nicola Cillara, Sandro Giannessi, Matteo Chiozza, Dario Parini, Omar Ghazouani, Manuela Mastronardi, E Gelarda, Luigi Marano, Francesca Lo Celso, Anna Maffioli, Daniele Delogu, Ana Lavinia Apostu, Federica Gonella, Luigi Zorcolo, Corrado Bottini, Simona Deidda, Franco Roviello, Gianluca Grillone, Francesco Cobellis, L. Carbone, Antonio Marrosu, Diego Sasia, Virna Robustelli, Paolo Massucco, Francesco Ferrara, Andrea Lauretta, Giovanni Domenico De Palma, Carmela Di Martino, G Zaffaroni, Angelo Restivo, Danilo Donati, Giuseppe Canonico, Daniele Marrelli, Antonio Frena, Diletta Cassini, Sara Pollesel, Giacomo Bertelli, Giovanni Cestaro, Marco Piccino, Andrea Micalef, Rino Baldan, Roberto Scola, Maria Sole Mattei, Sara Vertaldi, Maria Carmela Giuffrida, Luca Ippolito, Elvira Adinolfi, Marco Stella, F Alessi, M Garino, Gabriele Carbone, Alice Gabrieli, Luigi Cobellis, Massimo Fedi, Simone Lorenzo Birolo, Marco Della Sanità, Francesca Savastano, N. de Manzini, Gianandrea Baldazzi8, David Merlini, Antonio Langone, Peter Marinello, Harmony Impellizzeri, Gabriele Anania, Leonardo Montemurro, Massimo Petrella, Francesco Pata, Claudio Belluco, Gianluca Rizzo, Marco Milone, On behalf of MISSTO Snapshot Study Collaborative, Gian Luca Baiocchi, Paola De Nardi, Creciun Mihail
article en

Abstract

Dehydration is a frequent complication among rectal cancer patients after ileostomy, often resulting in hospital readmission. The Dehydration Readmission after Ileostomy Prediction (DRIP) score was used to identify patients at risk of dehydration-related readmission. The aim of this study is to assess the predictive value of the DRIP score for dehydration-electrolyte imbalance (DIE) and hospital readmission in a multicenter Italian cohort. A total of 306 patients with rectal adenocarcinoma who underwent anterior resection with protective ileostomy in 2022 were included. The main outcome measures were the incidence of early and late DIE, hospital readmission due to DIE, and correlations between the DRIP score and other clinical variables. Early DIE occurred in 16.3% of the patients, with 2.6% requiring readmission. Late DIE occurred in 13.7% of the patients, with 3.6% requiring readmission. The DRIP score was significantly correlated with early DIE. A high DRIP score was associated with an increased risk of early and late DIE. Independent predictors of early DIE included high BMI and early postoperative complications. Parastomal infection was the only independent predictor of late readmission. The DRIP score represents a useful tool for identifying patients at risk of early dehydration following ileostomy. While its ability to predict hospital readmission is limited, it provides clinically relevant risk stratification for early DIE and may support targeted postoperative monitoring strategies. Future studies should integrate dynamic patient-specific data to increase the predictive accuracy of the score and guide both inpatient and outpatient care.

Updates in Surgery
University of Siena (IT), Università Cattolica del Sacro Cuore (IT), University of Padua (IT), University of Sassari (IT), University of Cagliari (IT), Luigi Sacco Hospital (IT), Ospedale di Bolzano (IT), Milano Metropoli Development Agency (IT), Ospedale di Cattinara (IT), Ospedale San Carlo (IT), Nuovo Ospedale San Giovanni di Dio (IT), Casa di Cura Villa Garda (IT), ATS Sardegna (Italy) (IT), Azienda Sanitaria Locale di Asti (IT), Ospedale San Paolo (IT), Federico II University Hospital (IT), Istituto Ortopedico Rizzoli (IT), Santissima Trinità (IT), Arcispedale Sant'Anna (IT), University of Campania "Luigi Vanvitelli" (IT), Centro di Riferimento Oncologico (IT), A. O. Ordine Mauriziano di Torino (IT), Istituto Tumori Bari (IT), Ospedale Sandro Pertini (IT), Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT), Azienda Ospedaliera Sant’Antonio Abate di Gallarate (IT), Ospedale Santa Maria della Misericordia di Rovigo (IT), Ospedale degli Infermi (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Azienda Ospedaliera Ospedale Civile di Legnano (IT), Azienda Ospedaliera Carlo Poma (IT), Istituti Ospitalieri di Cremona (IT), Aziende Socio Sanitaria Territoriale Rhodense, Azienda Socio Sanitaria Territoriale di Cremona, Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo, University of Calabria (IT), University of Palermo (IT)
Università degli Studi di Palermo
Good health and well-being
Openalex Percentile: Top 9%
Stoma care and complications
DOIOpen Access PDFOpenAlex
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