Evolving Management Strategies in Patients with Adhesive Small Bowel Obstruction: a Population-Based Analysis

Background In patients with adhesive small bowel obstruction (aSBO), the decision to operate as well as the timing and technique of surgery have significant impacts on clinical outcomes. Trends in the management of aSBO have not been described at the population level and guideline adherence is unkno...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2018-12, Vol.22 (12), p.2133-2141
Main Authors: Behman, Ramy, Nathens, Avery B., Look Hong, Nicole, Pechlivanoglou, Petros, Karanicolas, Paul J
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Female
Gastroenterology
Gastrointestinal surgery
Hospitalization - trends
Humans
Intestinal obstruction
Intestinal Obstruction - epidemiology
Intestinal Obstruction - etiology
Intestinal Obstruction - surgery
Intestine, Small - surgery
Laparoscopy
Laparoscopy - statistics & numerical data
Male
Medicine
Medicine & Public Health
Middle Aged
Ontario - epidemiology
Original Article
Population
Retrospective Studies
Small intestine
Surgery
Time-to-Treatment - statistics & numerical data
Tissue Adhesions - epidemiology
Tissue Adhesions - etiology
Tissue Adhesions - surgery
Treatment Outcome
Trends
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Summary:Background In patients with adhesive small bowel obstruction (aSBO), the decision to operate as well as the timing and technique of surgery have significant impacts on clinical outcomes. Trends in the management of aSBO have not been described at the population level and guideline adherence is unknown. We sought to evaluate the secular trends in the management of aSBO in a large North American population. Methods We used administrative data to identify patients admitted to hospital for their first episode of aSBO over 2005–2014. We evaluated temporal trends in admission for aSBO and in management practices using Cochran-Armitage tests. Multivariable logistic regressions were used to assess trends when controlling for potential confounders. Results Patients (40,800) were admitted with their first episode of aSBO. The mean age was 68.5 years and 55% of patients were female. The population-based rate of admission for aSBO decreased over the study period, from 39.1 to 38.1 per 100,000 persons per year. There was a significant increase in the proportion of patients who underwent surgery for aSBO (19 to 23%, p  
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-018-3881-z