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European Journal of Trauma and Emergency Surgery

Erschienen in:

14.11.2021 | Original Article

Surgical management and outcomes of adhesive small bowel obstruction: teaching versus non-teaching hospitals

verfasst von: Matthew J. Carr, Jayraan Badiee, Derek A. Benham, Joseph A. Diaz, Richard Y. Calvo, Carol B. Sise, Matthew J. Martin, Vishal Bansal

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 1/2022

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Abstract

Background

The relationship between surgical management of adhesive small bowel obstruction (ASBO) and hospital teaching status is not well known. We sought to elucidate the association between hospital teaching status and clinical metrics for ASBO.

Methods

Using the 2007–2017 California Office of Statewide Health Planning and Development database, we identified adult ASBO patients hospitalized for surgical intervention. Hospital teaching status was categorized as major teaching (MajT), minor teaching (MinT), and non-teaching (NT). Cox proportional hazards modeling was used to evaluate risk of death and other adverse outcomes.

Results

Of 25,047 admissions, 15.4% were at MajT, 32.0% at MinT, and 52.6% at NT; 2.9% died. Patients at MajT had longer overall hospital stays (HLOS) than those at MinT or NT (median days 9 vs. 8 vs. 8; p = 0.005), longer post-ASBO procedure HLOS (median days 7 vs. 6 vs. 6; p = 0.0001) and higher rates of small bowel resection (27.1% vs. 21.7% vs. 21.7%; p < 0.0001). Mean time to first surgery at MajT was 3.3 days compared with 2.6 days (p = 0.004) at MinT and NT. Compared with patients at NT, those at MajT were significantly less likely to die (HR 0.62, p < 0.0001), develop pneumonia (HR 0.57, p = 0.001), or experience adverse discharge disposition (HR 0.79, p < 0.0001).

Conclusion

Mortality and morbidity of ASBO surgery were reduced at MajT; however, time to surgery, HLOS, and rate of small bowel resection were greater. These findings may guide improvements in the management of ASBO patients.

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Titel: Surgical management and outcomes of adhesive small bowel obstruction: teaching versus non-teaching hospitals
verfasst von: Matthew J. Carr
Jayraan Badiee
Derek A. Benham
Joseph A. Diaz
Richard Y. Calvo
Carol B. Sise
Matthew J. Martin
Vishal Bansal
Publikationsdatum: 14.11.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 1/2022
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01812-y

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Surgical management and outcomes of adhesive small bowel obstruction: teaching versus non-teaching hospitals