RISK FACTORS FOR REOPERATION, MORBIDITY, AND MORTALITY IN PATIENTS WITH SMALL BOWEL OBSTRUCTION SUBMITTED TO SURGICAL...

Area of Science:

• Gastroenterology
• Surgical Outcomes Research
• Abdominal Surgery

Background:

• Small bowel obstruction (SBO) is a common reason for emergency surgical admissions.
• Identifying risk factors for adverse outcomes is crucial for improving patient management.

Purpose of the Study:

• To determine risk factors for reoperations, postoperative adverse events, and operative mortality (OM) in surgically treated SBO patients.
• To enhance clinical decision-making and patient care strategies for SBO.

Main Methods:

• Retrospective study of 218 patients undergoing SBO surgery between 2014-2017.
• Statistical analysis using STATA 14, with significance set at p<0.05.
• Exclusion of gastric outlet obstruction, large bowel obstruction, and incomplete records.

Main Results:

• 88.5% of patients had prior abdominal surgery; 28.4% required intestinal resection.
• Postoperative adverse events (POAE) occurred in 28.4%, reoperations in 9.2%, and 90-day operative mortality (OM) in 5.9%.
• Risk factors for reoperation included intestinal resection, prolonged ICU stay (>3 days), and prolonged nasogastric tube (NGT) use (>7 days). Age, C-reactive protein, and intestinal resection were linked to POAE. OM was associated with prolonged NGT use and POAE.

Conclusions:

• Patient age, preoperative C-reactive protein, need for intestinal resection, and postoperative variables, particularly POAE, significantly influence the postoperative course.
• These findings highlight critical areas for intervention to reduce complications and mortality in SBO surgery.
• Further research into optimizing care pathways for high-risk SBO patients is warranted.