title: Outcomes After Surgery for Benign and Malignant Small Bowel Obstruction.
abstract: Small bowel obstruction (SBO) is a common diagnosis; however, outcomes of and risk factors for SBO and malignant bowel obstruction (MBO) surgery are not well understood. We sought to characterize outcomes and risk factors for surgery for SBO and MBO.
  
  
  
  A retrospective cohort study was performed utilizing prospectively collected data from the Michigan Surgical Quality Collaborative (7/2012-3/2015). Cases included those with ICD9 diagnosis code of bowel obstruction and CPT codes for lysis of adhesions, intestinal bypass, and small bowel resection. Cases were stratified by disseminated malignancy (MBO). Factors associated with complications and 30-day mortality were evaluated.
  
  
  
  Two thousand two hundred thirty-three patients underwent surgery for bowel obstruction, including 86 patients (3.9 %) with MBO. MBO patients had an adjusted mortality rate of 14.5 % (benign 5.0 %); the adjusted complication rate was 32.2 % (benign 27.0 %). Factors independently associated with mortality included disseminated cancer, older age, American Society of Anesthesiologists IV/V, cirrhosis, ascites, urinary tract infection, sepsis, albumin <3.5, hematocrit <30, and bowel resection.
  
  
  
  Surgery for bowel obstruction carries a relatively high risk for morbidity and mortality, particularly in patients with malignant bowel obstruction. Considering the identified risk factors for mortality may help clinicians make recommendations regarding surgery in the setting of MBO.
authors: Department of Surgery, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA. lwancata@med.umich.edu.
authors: Lauren M
authors: LM
authors: Wancata
authors: Department of Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
authors: Zaid M
authors: ZM
authors: Abdelsattar
authors: Department of Surgery, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.
authors: Pasithorn A
authors: PA
authors: Suwanabol
authors: Michigan Surgical Quality Collaborative, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
authors: Darrell A
authors: DA
authors: Campbell
authors: Department of Surgery, University of Michigan, 2124 Taubman Center, 1500 E. Medical Center Dr., SPC 5343, Ann Arbor, MI, 48109, USA.
authors: Samantha
authors: S
authors: Hendren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Malignant bowel obstruction; Outcomes; Small bowel obstruction; Surgery