title: Early outcomes of surgery for small bowel obstruction: analysis of risk factors.
abstract: OBJECTIVE
  The study aimed to review the etiologies of patients who underwent surgery for small bowel obstruction (SBO) and to evaluate the risk factors affecting the early postoperative outcomes.
  
  
  METHODS
  A case series of 430 patients (252 men) with a mean age of 64.5 years, who underwent 437 operations for SBO, were retrospectively reviewed.
  
  
  RESULTS
  Peritoneal adhesions and hernia were the most common causes of SBO, contributing 42.3 and 26.8% of all cases, respectively. Strangulation occurred in 27.7% and caused nonviable bowel in 13.0% of obstructing episodes. Old age (age >/= 70 years), female patient, nonadhesive obstruction, and hernia were the independent significant factors associated with bowel strangulation. The 30-day mortality was 6.5%, and the median postoperative hospital stay was 8 days. Old age, the presence of premorbid pulmonary disease, and malignant obstruction were the independent factors associated with operative mortality. The overall complication rate was 35.5%, and old age was the only significant factor associated with postoperative complications.
  
  
  CONCLUSIONS
  Surgery for SBO is still associated with significant mortality and morbidity. As old age is significantly associated with an increased incidence of strangulation, operative mortality, and complications, this group of patients should be managed with extra cautions to avoid unfavorable outcome of surgery.
authors.affiliation: Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam Road, Hong Kong, China.
authors.forename: Oswens Siu Hung
authors.initials: OS
authors.lastname: Lo
authors.forename: Wai Lun
authors.initials: WL
authors.lastname: Law
authors.forename: Hok Kwok
authors.initials: HK
authors.lastname: Choi
authors.forename: Yee Man
authors.initials: YM
authors.lastname: Lee
authors.forename: Judy Wai Chu
authors.initials: JW
authors.lastname: Ho
authors.forename: Chi Leung
authors.initials: CL
authors.lastname: Seto
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D000267:Tissue Adhesions / Q000150:complications; D016896:Treatment Outcome