title: Small bowel volvulus in the adult populace of the United States: results from a population-based study.
abstract: BACKGROUND
  Small bowel volvulus is a rare entity in Western adults. Greater insight into epidemiology and outcomes may be gained from a national database inquiry.
  
  
  METHODS
  The Nationwide Inpatient Sample (1998 to 2010), a 20% stratified sample of United States hospitals, was retrospectively reviewed for small bowel volvulus cases (International Classification of Diseases, 9th Edition [ICD-9] code 560.2 excluding gastric/colonic procedures) in patients greater than or equal to 18 years old.
  
  
  RESULTS
  There were 2,065,599 hospitalizations for bowel obstruction (ICD-9 560.x). Of those, there were 20,680 (1.00%) small bowel volvulus cases; 169 were attributable to intestinal malrotation. Most cases presented emergently (89.24%) and operative management was employed more frequently than nonoperative (65.21% vs 34.79%, P < .0001). Predictors of mortality included age greater than 50 years, Charlson comorbidity index greater than or equal to 1, emergent admission, peritonitis, acute vascular insufficiency, coagulopathy, and nonoperative management (P < .0001).
  
  
  CONCLUSIONS
  As the first population-based epidemiological study of small bowel volvulus, our findings provide a robust representation of this rare cause of small bowel obstruction in American adults.
authors.affiliation: Department of Surgery, University of California San Diego, UC San Diego Health System, San Diego, CA, USA.
authors.forename: Taylor M
authors.initials: TM
authors.lastname: Coe
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Chang
authors.affiliation: Department of Surgery, University of California San Diego, UC San Diego Health System, San Diego, CA, USA. Electronic address: jsicklick@ucsd.edu.
authors.forename: Jason K
authors.initials: JK
authors.lastname: Sicklick
mesh_terms: D004065:Digestive System Abnormalities; D006801:Humans; D045822:Intestinal Volvulus / Q000150:complications / Q000151:congenital / Q000453:epidemiology* / Q000209:etiology; D007421:Intestine, Small; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Acute abdomen; Charlson comorbidity; Intestinal malrotation; National inpatient sample; Small bowel volvulus