Acessibilidade / Reportar erro

RISK FACTORS FOR REOPERATION, MORBIDITY, AND MORTALITY IN PATIENTS WITH SMALL BOWEL OBSTRUCTION SUBMITTED TO SURGICAL TREATMENT

FATORES DE RISCO PARA REOPERAÇÃO E MORBIMORTALIDADE EM PACIENTES COM OBSTRUÇÃO DE INTESTINO DELGADO SUBMETIDOS A TRATAMENTO CIRÚRGICO

ABSTRACT - BACKGROUND:

Small bowel obstruction (SBO) is a frequent cause of emergency department admissions.

AIM:

This study aimed to determine risk factors of reoperations, postoperative adverse event, and operative mortality (OM) in patients surgically treated for SBO.

METHODS:

This is a retrospective study conducted between 2014 and 2017. Exclusion criteria include gastric outlet obstruction, large bowel obstruction, and incomplete clinical record. STATA version 14 was used for statistical analysis, with p-value <0.05 with 95% confidence interval considered statistically significant.

RESULTS:

A total of 218 patients were included, in which 61.9% were women. Notably, 88.5% of patients had previous abdominal surgery. Intestinal resection was needed in 28.4% of patients. Postoperative adverse event was present in 28.4%, reoperation was needed in 9.2% of cases, and a 90-day surgical mortality was 5.9%. Multivariate analysis determined that intestinal resection, >3 days in intensive care unit (ICU), >7 days with nasogastric tube (NGT), pain after postoperative day 3, POAE, and surgical POAE were the risk factors for reoperations, while age, C-reactive protein, intestinal resection, >3 days in ICU, and >7 days with NGT were the risk factors for POAE. OM was determined by >5 days with NGT and POAE.

CONCLUSIONS:

Postoperative course is determined mainly for patient’s age, preoperative level of C-reactive protein, necessity of intestinal resection, clinical postoperative variables, and the presence of POAE.

HEADINGS:
Intestine, Small; Intestinal Obstruction; Risk Factors; Reoperation; Mortality

Colégio Brasileiro de Cirurgia Digestiva Av. Brigadeiro Luiz Antonio, 278 - 6° - Salas 10 e 11, 01318-901 São Paulo/SP Brasil, Tel.: (11) 3288-8174/3289-0741 - São Paulo - SP - Brazil
E-mail: revistaabcd@gmail.com