Acute Bowel Obstruction: Risk Factors of Adverse Outcomes Following Surgery

作者：Doklestic Krstina; Bajec Djordje; Stefanovic Branislava; Milic Natasa; Bumbasirevic Vesna; Sijacki Ana; Radenkovic Dejan; Stefanovic Branislav; Karamarkovic Aleksandar^*

来源：Healthmed, 2012, 6(5): 1846-1854.

• Acute bowel obstruction
• Surgery
• Risk factors
• Outcome

Objective: To identify the risk factors of the adverse outcomes following surgery for the acute bowel obstruction (ABO).
Methods: Annual cross-section included patients undergoing surgery for the acute bowel obstruction, at the Clinic for Emergency Surgery, from December 2009 to December 2010. Patients had non-resection procedures or bowel resection with the intestinal anastomosis or temporary intestinal diversion. Demographic and perioperative data as well as outcome results were collected. Stepwise logistic regression was used to build models predicting 30-day morbidity and mortality and derive risk index values.
Results: Out of 272 patients, 145 underwent non-resection surgical procedures and 127 underwent bowel resection. The median ICU stay and median hospital stay was significantly higher among patients who underwent bowel resection (p=0,001 and p<0.0001, respectively). Morbidity was 37.1%. In multivariate analysis, the variables with the highest risk values included age over 65 years and ASA class 4-5, for 30-day morbidity. The overall 30-day mortality was 10.3%. For 30-day mortality, age over 65 years, comorbidity conditions, ASA class 4-5 and malignant etiology of ABO were the variables with the highest risk values.
Conclusions: Advanced age and ASA score with delayed operation were the risk factors significantly associated with the increased complication rate, while the advanced age and ASA score, comorbidity and malignant etiology were the risk factors significantly associated with the increased death rate. Surgery type was not a predictor of the adverse outcomes. Identification of risk factors is useful to predict outcomes and provide supportive care to high-risk patients undergoing surgery for ABO.

• 出版日期2012
• 单位河北医科大学