Adhesive small bowel obstruction in octogenarians: A 6-year retrospective single-center analysis of clinical management and outcomes.
Adhesive small bowel obstruction
Octogenarians
Outcomes
elderly
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
27
02
2022
revised:
11
04
2022
accepted:
19
04
2022
pubmed:
29
4
2022
medline:
15
11
2022
entrez:
28
4
2022
Statut:
ppublish
Résumé
Few evidences are available on adhesive bowel obstruction (ASBO)management and outcomes in geriatric patients. One-hundred-twenty-eight patients aged 65-79 years were retrospectively compared to 77 patients aged ≥80 years. Aim of this study was to compare ASBO management and in-hospital course between patients aged 65-79 years and those over 80 years. Upfront surgery in octogenarians related with a higher rate of major complications (23.7%vs4.9%; p = 0.009) and longer hospitalization (8.8vs7.3 days; p = 0.01). No difference according to age was noted in terms of clinical outcomes when the non-operative management (NOM) was employed. Patients aged ≥80 years managed conservatively presented shorter hospitalization (7.3vs8.8 days; p = 0.04), lower rate of intensive care unit (ICU)admission (0vs18.4%; p = 0.005) and cumulative major complications (2.6%vs23.7%; p = 0.007) as compared to ≥80 years old patients treated with upfront surgery. In this same group, NOM failure did not lead to worse outcomes in comparison to upfront surgery. NOM in≥80 years patients is associated with better in-hospital course. The acceptable clinical outcomes in case of NOM failure further support NOM as first treatment strategy to employ in this same subset of patients.
Sections du résumé
BACKGROUND
Few evidences are available on adhesive bowel obstruction (ASBO)management and outcomes in geriatric patients.
METHODS
One-hundred-twenty-eight patients aged 65-79 years were retrospectively compared to 77 patients aged ≥80 years. Aim of this study was to compare ASBO management and in-hospital course between patients aged 65-79 years and those over 80 years.
RESULTS
Upfront surgery in octogenarians related with a higher rate of major complications (23.7%vs4.9%; p = 0.009) and longer hospitalization (8.8vs7.3 days; p = 0.01). No difference according to age was noted in terms of clinical outcomes when the non-operative management (NOM) was employed. Patients aged ≥80 years managed conservatively presented shorter hospitalization (7.3vs8.8 days; p = 0.04), lower rate of intensive care unit (ICU)admission (0vs18.4%; p = 0.005) and cumulative major complications (2.6%vs23.7%; p = 0.007) as compared to ≥80 years old patients treated with upfront surgery. In this same group, NOM failure did not lead to worse outcomes in comparison to upfront surgery.
CONCLUSIONS
NOM in≥80 years patients is associated with better in-hospital course. The acceptable clinical outcomes in case of NOM failure further support NOM as first treatment strategy to employ in this same subset of patients.
Identifiants
pubmed: 35477590
pii: S0002-9610(22)00257-4
doi: 10.1016/j.amjsurg.2022.04.019
pii:
doi:
Substances chimiques
Adhesives
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1209-1214Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare that they have no conflicts of interest.