title: Complications and death after surgical treatment of small bowel obstruction: A 35-year institutional experience.
abstract: OBJECTIVE
  To study factors influencing complications and death after operations for small bowel obstruction (SBO) using multifactorial statistical methods.
  
  
  BACKGROUND
  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.
  
  
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Haukeland University Hospital, University of Bergen, Bergen, Norway.
authors.forename: B T
authors.initials: BT
authors.lastname: Fevang
authors.forename: J
authors.initials: J
authors.lastname: Fevang
authors.forename: L
authors.initials: L
authors.lastname: Stangeland
authors.forename: O
authors.initials: O
authors.lastname: Soreide
authors.forename: K
authors.initials: K
authors.lastname: Svanes
authors.forename: A
authors.initials: A
authors.lastname: Viste
mesh_terms: D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000401:mortality*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors