title: [Effect of a clinical pathway in patients with Crohn's disease complicated with intestinal obstruction].
abstract: OBJECTIVE
  To evaluate the effect of a clinical pathway for Crohn disease (CD) complicated with intestinal obstruction.
  
  
  METHODS
  CD patients complicated with intestinal obstruction in Inflammatory Bowel Disease(IBD) Center of Jinling Hospital were enrolled. One hundred and nineteen CD patients from March 2014 to September 2015 received treatment with the clinical pathway (CP), which was developed based on medical evidence and experience of the IBD center in February 2014, as CP group. The other 108 CD patients from September 2012 to February 2014 received treatment according to the management strategy made by individual attending physician as non-CP group. Rate of operation, rate of stoma, morbidity of surgical complications, hospital stay, hospital cost, and 6-month unplanned re-admission were compared between two groups.
  
  
  RESULTS
  The baseline data were similar between the two group (all P > 0.05). No significant differences were noted between these the two groups in terms of rate of operation (73.9% vs. 77.8%, P = 0.605), rate of stoma (15.9% vs. 25.0%, P = 0.197), and morbidity of surgical complications (23.9% vs. 27.4%, P = 0.724). However, the mean postoperative hospital stay was shorter (10.9 d vs. 13.2 d, P = 0.000), the mean hospital cost was less (78 325 Yuan vs. 85 310 Yuan, P = 0.031) and the rate of 6-month unplanned re-admission was lower(3.4% vs. 11.1%, P = 0.035) in CP group.
  
  
  CONCLUSIONS
  Treatment based on this CP for CD patients complicated with intestinal obstruction can reduce the rate of 6-month unplanned re-admission, shorten the postoperative hospital stay and decrease the hospital cost in patients requiring surgery.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Guo
authors.forename: Lei
authors.initials: L
authors.lastname: Cao
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Gong
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.forename: Lili
authors.initials: L
authors.lastname: Gu
authors.affiliation: Department of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China. juwiming@nju.edu.cn.
authors.forename: Weiming
authors.initials: W
authors.lastname: Zhu
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D019091:Critical Pathways; D003424:Crohn Disease / Q000150:complications* / Q000628:therapy*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications* / Q000628:therapy*; D007431:Intraoperative Complications / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D054047:Surgical Stomas / Q000706:statistics & numerical data; D016896:Treatment Outcome