Factors influencing outcome in patients with gastrointestinal fistula

The occurrence of a gastrointestinal fistula spontaneously (associated with inflammatory bowel disease or cancer) or following an abdominal operation is associated with a marked increase in morbidity and mortality. Thus, the knowledge of the factors that influence outcome concerning the likelihood of spontaneous fistula closure and those that increase mortality would be of great value to the surgeon in the decision-making process. A review of the literature is undertaken to determine those prognostic factors that might serve as a guide to the general surgeon. It is recognized, however, that it is very difficult to conclude that the presence of a single prognostic factor increases the risk in patients as complex and heterogeneous as those with digestive fistulas.