Complications and death after surgical treatment of small bowel obstruction : A 35-year institutional experience

• Published in: Annals of surgery Vol. 231; no. 4; pp. 529 - 537
• Main Authors: FEVANG, B. T, FEVANG, J, STANGELAND, L, SØREIDE, O, SVANES, K, VISTE, A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.04.2000
• Subjects: Age Factors; Aged; Biological and medical sciences; Chi-Square Distribution; Comorbidity; Female; Humans; Intestinal Obstruction - etiology; Intestinal Obstruction - mortality; Intestinal Obstruction - surgery; Male; Medical sciences; Middle Aged; Odds Ratio; Original; Postoperative Complications - mortality; Reoperation; Retrospective Studies; Risk Factors; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Time Factors; Human; Occlusion; Postoperative; Concomitant disease; Statistical analysis; Etiology; Surgery; Risk factor; Gut; Digestive diseases; Intestinal disease; Complication
• ISSN: 0003-4932; 1528-1140
• DOI: 10.1097/00000658-200004000-00012

To study factors influencing complications and death after operations for small bowel obstruction (SBO) using multifactorial statistical methods. Death after surgery for SBO is believed to be influenced by factors such as old age, comorbidities, bowel gangrene, and delay in treatment. No studies have been reported in which adverse factors related to death and complications have been systematically investigated with modern statistical methods. The authors studied retrospectively 877 patients who underwent 1,007 operations for SBO from 1961 to 1995. Patients with paralytic ileus, intussusception, and abdominal cancer were excluded. Odds ratios for death, complications, postoperative hospital stay, and strangulation were calculated by means of logistic regression analyses. Death and complication rates decreased during the study period. Old age, comorbidity, nonviable strangulation, and a treatment delay of more than 24 hours were significantly associated with an increased death rate. The rate of nonviable strangulation increased markedly with patient age. Major factors increasing the complication rate were old age, comorbidity, a treatment delay of more than 24 hours, and the need for repeat surgery. Death and complication rates after SBO decreased from 1961 to 1995. Major factors influencing the rates were age, comorbidity, nonviable strangulation, and treatment delay. Nonviable strangulation was more common in old patients.