[Analysis of risk factors affecting operative outcome of small bowel obstruction].
OBJECTIVE
To evaluate the risk factors affecting the early postoperative outcomes in patients with small bowel obstruction.


METHODS
Clinical data of 193 patients with small bowel obstruction undergone operation were analyzed retrospectively. A range of factors were investigated to estimate postoperative outcome, including gender, age, comorbidities, etiology of obstruction, presence of strangulated bowel (viable or nonviable), leukocyte count, temperature, and heart rate. Logistic regression analysis was used to study the prognostic value of each significant variable in terms of postoperation.


RESULTS
The major causes of small bowel obstruction were adhesion and hernia, contributing 38.9% and 37.8% of all cases, respectively. Strangulation occurred in 42.0% and caused nonviable bowel in 23.3% of obstructing episodes. Elderly (>or=70 years), diabetes, malignant tumors WBC >15x10(9)/L were independent significant factors associated with bowel strangulation. The overall complication rate was 16.1%, the 30-day mortality was 4.1%, and the median postoperative hospital stay was 13 days. Age >or=70 years and bowel resection were significantly associated with postoperative complications in the univariate analysis. Only elderly and malignant obstruction were significantly associated with operative mortality in multivariate logistic regression.


CONCLUSIONS
Surgery for small bowel obstruction is still associated with significant mortality and morbidity. Elderly is significantly associated with an increased incidence of strangulation, operative mortality, and complications.
Wang
Zhong-lin
ZL
Department of General Surgery, The Second People's Hospital of Wenzhou, Zhejiang, Wenzhou, China. phl15507@163.com
Pan
Zhong-liang
ZL
Sun
Wei
W
Xu
Jian-min
JM
Lin
Hai-qing
HQ
Wan
Tao
T
Huang
Jie
J
He
Jie
J
Wang
Yi
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D007416:Intestinal Perforation / Q000453:epidemiology; D007421:Intestine, Small / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult