Admitting Service and Outcome for Small Bowel Obstruction

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Health Services Research

Background:

• Small bowel obstruction (SBO) is a frequent cause of hospital admission.
• Previous studies indicate surgical services (SS) may offer advantages over medical services (MS) for SBO patients regarding length of stay and time to operation.
• The impact of the admitting service on SBO patient readmission and mortality remains to be fully elucidated.

Purpose of the Study:

• To evaluate the effect of admitting service (surgical vs. medical) on readmission rates and mortality in patients diagnosed with small bowel obstruction.
• To compare outcomes between patients admitted to surgical services versus medical services for SBO.

Main Methods:

• A 12-year retrospective cohort study was conducted within a single healthcare system.
• Data from 7921 adult patients admitted with SBO were analyzed.
• Statistical methods included Student's t-test, chi-square, and multivariable regression analyses.

Main Results:

• Admission to a surgical service (SS) was associated with significantly decreased mortality at admission, 30-day, and 180-day intervals.
• Patients on SS also experienced significantly lower 30-day and 180-day readmission rates compared to those on medical services (MS).
• These benefits persisted even when analyzing patients who underwent a procedure during their admission.

Conclusions:

• Admitting patients with SBO to surgical services is associated with reduced odds of mortality and readmission.
• Further research is warranted to identify specific management strategies on SS that contribute to these improved outcomes.
• Findings support the potential refinement of hospital admission pathways for SBO to enhance patient outcomes.