ทำออสโตมหรอตอลำไส? ปจจยทำนายอสระของการทำออสโตมในการผาตดลำไสใหญและทวารหนกแบบฉกเฉน ณ โรงพยาบาลทวไประดบจงหวดทมทรพยากรจำกด: การศกษายอนหลง 10 ป (พ.ศ.2558-2568)

Objective

The intraoperative decision to restore bowel continuity or create a stoma during emergency colorectal resection is complex, and the factors that drive this decision remain poorly characterised, particularly in resource-limited settings. We aimed to identify independent predictors of stoma creation among adults undergoing emergency colorectal resection at a Thai provincial referral hospital. Materials and Methods: We conducted a retrospective cohort study of consecutive adult patients undergoing emergency colorectal resection at Phatthalung Hospital, a provincial referral hospital in southern Thailand, between January 2015 and December 2025. Candidate predictors spanning eight pre-specified domains—demographic characteristics, body mass index, physiological reserve, physiological compromise, immunonutritional status, disease characteristics, surgeon factors, and operative context—were evaluated using univariable and Firth penalised multivariable logistic . A full model incorporating all covariates and a physiologic model excluding disease location (to isolate non-anatomical predictors) were compared.