This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Population‐based study of the impact of small bowel obstruction due to adhesions on short‐ and medium‐term mortality.
Published: 9th August 2019
Authors: R. Behman, A. B. Nathens, B. Haas, N. Look Hong, P. Pechlivanoglou, P. Karanicolas et al.
Background
Small bowel obstruction due to adhesions (aSBO) is a common indication for admission to a surgical unit. Despite the prevalence of this condition, the short‐ and medium‐term survival of this patient population has not been well described. The purpose of this study was to measure the short‐ and medium‐term survival of patients admitted to hospital with aSBO.
Method
Linked administrative data were used to identify patients admitted to hospital in Ontario, Canada, for aSBO between 2005 and 2011. Patients were divided into two groups: those aged less than 65 years (younger group) and those aged 65 years and older (older group). Thirty‐day, 90‐day and 1‐year mortality rates were estimated. One‐year mortality was compared with that in the general population, adjusting for age and sex. The timing of deaths in relation to admission was assessed, as well as the proportion of patients discharged before experiencing short‐term mortality.
Results
There were 22 197 patients admitted to hospital for aSBO for the first time in the study interval. Mean age was 64·5 years and 52·2 per cent of the patients were women. Overall, the 30‐day, 90‐day and 1‐year mortality rates for the cohort were 5·7 (95 per cent c.i. 5·4 to 6·0), 8·7 (8·3 to 9·0) and 13·9 (13·4 to 14·3) per cent respectively. For both groups, the 1‐year risk of death was significantly greater than that of the age‐matched general population. The majority of deaths (62·5 per cent) occurred within 90 days of admission, with 36·4 per cent occurring after discharge from the aSBO admission.
Conclusion
Patients admitted with aSBO have a high short‐term mortality rate. Increased monitoring of patients in the early period after admission is advisable.
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