Should Surgical Services Admit Small Bowel Obstructions Managed Non-operatively?

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Healthcare Management

Background:

• Small bowel obstruction (SBO) management has increasingly shifted towards non-operative approaches over the last decade.
• Previous research on SBO outcomes often focused on operative patients, leaving a gap in understanding non-operative care.
• This study specifically examines the outcomes of patients with non-operative SBO.

Purpose of the Study:

• To evaluate the outcomes of non-operative small bowel obstruction (SBO) patients based on their admission service.
• To compare length of stay, mortality rates, and readmission rates between patients admitted to surgical services (SS) versus medicine services (MS).

Main Methods:

• A 12-year retrospective cohort study included adult patients admitted with SBO within a single healthcare system.
• Data from 3278 non-operative SBO patients were analyzed, focusing on clinicodemographic characteristics and admission details.
• Statistical analyses included student's t-test, chi-square, and multivariable regression to compare outcomes between SS and MS admissions.

Main Results:

• Admission to a surgical service (SS) was associated with a significantly decreased length of stay (3.4 vs 4.1 days).
• SS admissions led to lower in-hospital mortality (0.1% vs 2.2%) and reduced 30-day (OR 0.15) and 180-day mortality (OR 0.307).
• Readmissions within 30 days (OR 0.683) and 180 days (OR 0.54) were also significantly lower for patients admitted to SS.

Conclusions:

• For non-operative small bowel obstruction (SBO), admission to a surgical service is linked to improved outcomes, including shorter hospital stays and reduced mortality.
• The findings support the practice of admitting SBO patients to surgical services for potentially better short-term outcomes.
• Further research is recommended to explore the impact of comorbidities on long-term outcomes in this patient population.