Survival after operations for ischaemic bowel disease

To find out what factors influence the outcome of operations for ischaemic bowel disease.

Retrospective study.

University hospital, Sweden.

Morbidity and mortality.

74 patients, mean age 75 years (range 40-98), operated on for acute bowel ischaemia between 1987 and 1996.

A total of 75 emergency operations were done, including 42 bowel-resections, one percutaneous transluminal angioplasty, and one thrombectomy. Thirty-one patients had exploration alone because of extensive gangrene. These explorations were performed in 11 of 14 (79%) patients aged >84 years; 18 of 40 (45%) patients aged 71-84 years and 2 of 21 (9%) patients aged <71 years, (p < 0.001). Of the 14 patients over 84 years old only one survived more than 30 days, compared with 12 of 40 (30%) aged 71-84 years, and 17 of 21 (81%) younger than 71 years (p < 0.001). Operation within 6 hours of admission resulted in significantly better survival compared with operations done after more than 6 hours delay (p = 0.04).

Advanced age was a strong risk factor for death after operation for ischaemic bowel disease, and there was a higher incidence of unresectable gangrene. Delay in surgical intervention was associated with increasing mortality.