title: Secular trends in small-bowel obstruction and adhesiolysis in the United States: 1988-2007.
abstract: BACKGROUND
  Postoperative adhesions are common after surgery and can cause small-bowel obstruction (SBO) and require adhesiolysis. The impact that laparoscopy and other surgical advances have had on rates of SBO and adhesiolysis remains controversial. This study examines trends in discharges from US hospitals for SBO and adhesiolysis from 1988 to 2007.
  
  
  METHODS
  We performed an analysis of secular trends for SBO and adhesiolysis, using the National Hospital Discharge Survey. Spearman correlation coefficients were calculated to assess trends over time.
  
  
  RESULTS
  Rates of SBO were stable over time (ρ = .140; P = .28). Adhesiolysis rates were stable over time (ρ = -.18; P = .17), although there were significant downward trends in patients older than age 65 (ρ = -.55; P = .01) and age 15 to 44 (ρ = -.84; P < .01).
  
  
  CONCLUSIONS
  There has been no significant change in overall rates of SBO or adhesiolysis from 1988 to 2007. For adhesiolysis, there were decreasing trends when stratified by age. Further research is required to understand the factors associated with adhesion-related complications.
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce St., Ravdin 3, Philadelphia, PA 19104, USA. frankis@mail.med.upenn.edu
authors.forename: Frank I
authors.initials: FI
authors.lastname: Scott
authors.forename: Mark T
authors.initials: MT
authors.lastname: Osterman
authors.forename: Najjia N
authors.initials: NN
authors.lastname: Mahmoud
authors.forename: James D
authors.initials: JD
authors.lastname: Lewis
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data / Q000639:trends*; D000267:Tissue Adhesions / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology