BACKGROUND: We evaluated the effects of factors related to both the patient and the treatment on morbidity and mortality of patients with mechanical intestinal obstruction. METHODS: A total of 152 patients (83 males, 69 females; mean age 55.05 years; range 15 to 90 years) who underwent surgery for intestinal obstruction were retrospectively evaluated. The effect of several factors on morbidity and mortality during hospitalization (mean 8.6 days; range 1 to 105 days) was assessed, including age, sex, associated diseases, the presence of intestinal necrosis, previous abdominal operations, the time of the operation, and the level of obstruction. Statistical evaluations were made with the use of a multiple logistic regression analysis. RESULTS: Complications were encountered in 52 patients (34.2%), the most common being systemic complications (15.8%) followed by wound site infections (11.2%). During hospitalization, mortality occurred in six patients (4%), all of whom had at least one associated disease. Logistic regression analysis showed that age beyond 75 years (p<0.01), male gender (p<0.01), associated disease (p<0.05), non-viable strangulation (p<0.001), previous operations (p<0.05) and malignancies (p<0.05) were significant independent factors affecting the complication rate. On the other hand, only non-viable strangulation (p<0.05) had significant independent effect on mortality. CONCLUSION: Patient-related factors should be taken into consideration in the evaluation and treatment of mechanical intestinal obstruction.
BACKGROUND: We evaluated the effects of factors related to both the patient and the treatment on morbidity and mortality of patients with mechanical intestinal obstruction. METHODS: A total of 152 patients (83 males, 69 females; mean age 55.05 years; range 15 to 90 years) who underwent surgery for intestinal obstruction were retrospectively evaluated. The effect of several factors on morbidity and mortality during hospitalization (mean 8.6 days; range 1 to 105 days) was assessed, including age, sex, associated diseases, the presence of intestinal necrosis, previous abdominal operations, the time of the operation, and the level of obstruction. Statistical evaluations were made with the use of a multiple logistic regression analysis. RESULTS: Complications were encountered in 52 patients (34.2%), the most common being systemic complications (15.8%) followed by wound site infections (11.2%). During hospitalization, mortality occurred in six patients (4%), all of whom had at least one associated disease. Logistic regression analysis showed that age beyond 75 years (p<0.01), male gender (p<0.01), associated disease (p<0.05), non-viable strangulation (p<0.001), previous operations (p<0.05) and malignancies (p<0.05) were significant independent factors affecting the complication rate. On the other hand, only non-viable strangulation (p<0.05) had significant independent effect on mortality. CONCLUSION:Patient-related factors should be taken into consideration in the evaluation and treatment of mechanical intestinal obstruction.
Authors: Carlo Vallicelli; Federico Coccolini; Fausto Catena; Luca Ansaloni; Giulia Montori; Salomone Di Saverio; Antonio D Pinna Journal: World J Emerg Surg Date: 2011-01-07 Impact factor: 5.469