Delayed return of bowel function after general surgery in South Australia

Area of Science:

• General Surgery
• Gastroenterology
• Clinical Outcomes Research

Background:

• Postoperative return of bowel function is crucial but lacks defined reference ranges in general surgery.
• Understanding factors influencing delayed bowel function is key for patient management.

Purpose of the Study:

• To characterize the time to first postoperative stool passage in general surgery patients.
• To identify clinical factors associated with delayed first postoperative stool.
• To evaluate the impact of delayed stool passage on length of hospital stay.

Main Methods:

• A retrospective study of 2,212 general surgery patients from two tertiary hospitals over two years.
• Multivariable logistic regression was used to analyze associations between clinical factors and delayed stool passage (≥4 days).
• The association between delayed stool passage and prolonged length of stay (≥7 days) was assessed.

Main Results:

• Median time to first stool passage was 2.28 days (IQR 1.06-3.96).
• Several operative characteristics and medication exposures were linked to delayed stool passage.
• A delayed first postoperative stool (≥4 days) was significantly associated with a prolonged length of stay (≥7 days) (OR 4.34).

Conclusions:

• This study provides reference ranges for postoperative bowel function return in general surgery.
• Identified clinical factors can aid in optimizing postoperative care and identifying potential complications.
• A delay in first stool passage is a significant predictor of extended hospital stay.