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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
National prospective cohort study of the burden of acute small bowel obstruction
BJS Open, Volume 3, No. 3, Year 2019
Notification
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Description
Background: Small bowel obstruction is a common surgical emergency, and is associated with high levels of morbidity and mortality across the world. The literature provides little information on the conservatively managed group. The aim of this study was to describe the burden of small bowel obstruction in the UK. Methods: This prospective cohort study was conducted in 131 acute hospitals in the UK between January and April 2017, delivered by trainee research collaboratives. Adult patients with a diagnosis of mechanical small bowel obstruction were included. The primary outcome was in-hospital mortality. Secondary outcomes included complications, unplanned intensive care admission and readmission within 30 days of discharge. Practice measures, including use of radiological investigations, water soluble contrast, operative and nutritional interventions, were collected. Results: Of 2341 patients identified, 693 (29·6 per cent) underwent immediate surgery (within 24 h of admission), 500 (21·4 per cent) had delayed surgery after initial conservative management, and 1148 (49·0 per cent) were managed non-operatively. The mortality rate was 6·6 per cent (6·4 per cent for non-operative management, 6·8 per cent for immediate surgery, 6·8 per cent for delayed surgery; P = 0·911). The major complication rate was 14·4 per cent overall, affecting 19·0 per cent in the immediate surgery, 23·6 per cent in the delayed surgery and 7·7 per cent in the non-operative management groups (P < 0·001). Cox regression found hernia or malignant aetiology and malnutrition to be associated with higher rates of death. Malignant aetiology, operative intervention, acute kidney injury and malnutrition were associated with increased risk of major complication. Conclusion: Small bowel obstruction represents a significant healthcare burden. Patient-level factors such as timing of surgery, acute kidney injury and nutritional status are factors that might be modified to improve outcomes. © 2019 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of BJS Society Ltd
Authors & Co-Authors
Lee, Matthew J.
United Kingdom, Sheffield
Northern General Hospital
Drake, Thomas M.
United Kingdom, Edinburgh
The University of Edinburgh
Verjee, Azmina
United Kingdom, London
The Association of Coloproctology of Great Britain and Ireland
Fearnhead, Nicola S.
United Kingdom, Cambridge
Addenbrooke's Hospital
Alderson, Derek A.
Unknown Affiliation
Hamady, Zaed Z.R.
Unknown Affiliation
Singh, Pritam
Unknown Affiliation
Abdulaal, Yasser
Unknown Affiliation
Akhtar, Mansoor
Unknown Affiliation
Ali, Ahmad K.
Unknown Affiliation
Aly, Mohammed Yahia Mohamed
Unknown Affiliation
Bolkan, Håkon Angell
Unknown Affiliation
Brown, Jason N.
Unknown Affiliation
Butler, Marilyn West
Unknown Affiliation
Chapman, Jens Robert
Unknown Affiliation
Chapman, Stephen J.
Unknown Affiliation
Conaghan, Philip G.
Unknown Affiliation
Coyne, Patrick J.
Unknown Affiliation
Davies, Richard Justin
Unknown Affiliation
Elsaid, N. Y.
Unknown Affiliation
Evans, Jennifer L.
Unknown Affiliation
Francis, Nicholas D.
Unknown Affiliation
Glasbey, James C.
Unknown Affiliation
Hossaini, Sina
Unknown Affiliation
Jull, Patrick
Unknown Affiliation
Malik, Ahmad Azam
Unknown Affiliation
McNair, Angus G.K.
Unknown Affiliation
Merker, Ludwig
Unknown Affiliation
Mohamed, Imran M.
Unknown Affiliation
Moug, Susan Joan
Unknown Affiliation
Nowers, Jennifer
Unknown Affiliation
Nunn, Rebecca
Unknown Affiliation
Olivier, James B.
Unknown Affiliation
O'Neill, Stephen
Unknown Affiliation
Osei-Bordom, Daniel Clement
Unknown Affiliation
Carceller Navarro, María Soledad
Unknown Affiliation
Qureshi, Ahmad Uzair
Unknown Affiliation
Sadien, Iannish D.
Unknown Affiliation
Shaban, Fadlo
Unknown Affiliation
Shankar, Sushma
Unknown Affiliation
Singh, Shalini
Unknown Affiliation
Stylianides, Nicholas A.
Unknown Affiliation
Venn, Mary L.
Unknown Affiliation
Wafi, Arsalan
Unknown Affiliation
Walker, Mark C.
Unknown Affiliation
Watson, Nick T.
Unknown Affiliation
Zaman, Sojib Bin
Unknown Affiliation
Cook, Timothy M.
Unknown Affiliation
Lunevicius, Raimundas
Unknown Affiliation
McArthur, David R.
Unknown Affiliation
Sheel, Andrea Rhiannon Glynne
Unknown Affiliation
Smart, Neil J.
Unknown Affiliation
Thompson, Robert L.
Unknown Affiliation
Watson, Nicholas F.S.
Unknown Affiliation
Andreou, Alexandros G.
Unknown Affiliation
Berger, Claudie J.
Unknown Affiliation
Blencowe, Natalie S.
Unknown Affiliation
Boddy, Alexander P.
Unknown Affiliation
Boyer, Matthew J.
Unknown Affiliation
Brown, Julianne S.
Unknown Affiliation
Chapman, Stephen J.
Unknown Affiliation
Charalabopoulos, Alexandros
Unknown Affiliation
Conn, Gemma
Unknown Affiliation
Davies, James E.
Unknown Affiliation
Demetriou, George A.
Unknown Affiliation
Donnelly, Eric D.
Unknown Affiliation
Elsaid, Nashwa
Unknown Affiliation
Evans, Jessica D.
Unknown Affiliation
Fisher, Oliver M.
Unknown Affiliation
Fox, Rina S.
Unknown Affiliation
Francis, Nader Kamal
Unknown Affiliation
Haddow, James Boyd
Unknown Affiliation
Hawkins, Jessica
Unknown Affiliation
Heller, Simon R.
Unknown Affiliation
Jones, Laura L.
Unknown Affiliation
Moss, Jana Lee
Unknown Affiliation
Nassar, Ahmad H.M.
Unknown Affiliation
Nunn, Andrew J.
Unknown Affiliation
Parks, Rowan W.
Unknown Affiliation
Patel, Hiten D.
Unknown Affiliation
Petronio, Barbara
Unknown Affiliation
Seal, Sheila
Unknown Affiliation
Thompson, Ellen J.
Unknown Affiliation
Boland, Michael R.
Unknown Affiliation
Byrne, Benjamin E.
Unknown Affiliation
Lee, Kuok Chung
Unknown Affiliation
McKay, Siobhan Chloe
Unknown Affiliation
Mellor, Katie
Unknown Affiliation
Nunn, Rebecca
Unknown Affiliation
Venn, Mary L.
Unknown Affiliation
Statistics
Citations: 29
Authors: 90
Affiliations: 8
Identifiers
Doi:
10.1002/bjs5.50136
ISSN:
24749842
Research Areas
Cancer
Environmental
Food Security
Health System And Policy
Violence And Injury
Study Design
Randomised Control Trial
Cohort Study
Study Approach
Quantitative