Association of Postoperative Ileus With Length of Hospital Stay in Abdominal Surgery Patients

Postoperative ileus (POI) is a frequent complication following abdominal surgeries, characterized by delayed gastrointestinal motility and associated with increased patient morbidity and healthcare burden. This study aimed to determine the association between postoperative ileus and length of hospital stay (LOS) among patients undergoing abdominal surgery.

This retrospective observational study was conducted at District Headquarters (DHQ) Teaching Hospital, Gujranwala, Pakistan, from January 2024 to December 2024. A total of 335 patients were included in this study. Data were retrieved from patients' hospital files, surgical records, and discharge summaries. Collected variables included demographic details (age and gender), clinical characteristics (comorbidities such as diabetes and hypertension), surgical details (type of surgery, approach, and duration), postoperative opioid usage, development of POI, and total length of hospital stay.

POI occurred in 94 patients (28.1%). The mean LOS was significantly longer in the POI group (9.6±3.2 days) compared to those without POI (5.4±2.1 days; p<0.001). Open surgery, emergency procedures, operative time >120 min, and opioid use were significantly associated with POI. In logistic regression, POI independently predicted prolonged hospital stay (>7 days) with an adjusted odds ratio of 4.82 (95% CI: 2.91-7.98, p<0.001).

Postoperative ileus significantly prolongs hospital stay in patients undergoing abdominal surgery. Identifying high-risk patients and implementing preventive strategies such as minimizing opioid use, promoting early mobilization, and adopting minimally invasive techniques can reduce POI incidence and enhance postoperative recovery.