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Postoperative adhesive small bowel obstruction: the resources impacts.
M H Alwan1, A M van Rij, S F Greig
1Department of Surgery, Dunedin School of Medicine, University of Otago.
The New Zealand Medical Journal
|March 4, 2000
Summary
Managing small bowel obstruction, particularly postoperative adhesive cases, incurs significant healthcare costs and workload. This common condition leads to substantial patient morbidity and requires variable emergency management resources.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Health Economics
Background:
- Small bowel obstruction (SBO) is a frequent surgical emergency with varied etiologies and prognoses.
- Adhesive SBO, often a consequence of prior abdominal surgery, represents a significant subset of cases.
Purpose of the Study:
- To evaluate the resource implications, including costs and complications, associated with managing small bowel obstruction.
- To specifically assess the economic burden and clinical outcomes of postoperative adhesive small bowel obstruction.
Main Methods:
- A retrospective analysis of 332 patients with postoperative adhesive small bowel obstruction between 1988 and 1996.
- Data collection included hospital admissions, surgical interventions, length of stay, complications, and associated healthcare costs.
Main Results:
- Postoperative adhesive SBO accounted for a notable proportion of all bowel obstructions and laparotomies.
- Patients experienced a median hospital stay of eight days, with significant cost differences between operative and non-operative management.
- A considerable percentage of patients (20.5%) developed complications, and the overall mortality rate was 2.4%.
Conclusions:
- Postoperative adhesive small bowel obstruction is a prevalent condition contributing to substantial patient morbidity and healthcare system workload.
- The management of these cases incurs significant and highly variable healthcare costs, often necessitating emergency interventions.