Clinical Outcome and Predictors of Intestinal Obstruction Surgery in Ethiopia: A Cross-Sectional Study

Abstract

Background. Despite the advancement in the healthcare system, the impact of surgical interventions on public health systems will continue to grow. But predicting the outcome is challenging. Concerns related to unexpected outcomes and delays in the diagnosis of postoperative complications are the major issue. Intestinal obstruction is a common life-threatening surgical condition followed by fatal and nonfatal postoperative complications. This study was aimed at assessing results after surgery for intestinal obstruction in a hospital of Ethiopia. Methodology. An institutional-based cross-sectional study was conducted among 254 postoperative patients admitted with intestinal obstruction from January 1, 2014, to December 31, 2017. Data were coded and entered into EpiData 4.2.0.0 software and exported to the Statistical Package for the Social Sciences version 22 for analysis. A binary logistic regression model was used for analysis. All variables with a p value < 0.25 during bivariable analysis were considered for multivariable logistic regression analysis. Results. The magnitude of poor surgical outcome of intestinal obstruction was 21.3% for patients enrolled into this investigation. The age group of ≥55 years ( adjusted odds ratio AOR = 2.9 , 95% CI: 1.03, 8.4), duration of illness of ≥24 hrs ( AOR = 3.1 , 95% CI: 1.03, 9.4), preoperative diagnosis of a gangrenous large bowel ( AOR = 3.6 , 95% CI: 1.3, 9.8), and a gangrenous small bowel ( AOR = 4.2 , 95% CI: 1.3, 13.7) were significantly associated with poor surgical outcome. Conclusions. The magnitude of poor surgical outcome was high. Age, late presentation of illness, and gangrenous bowel obstructions were significantly associated with poor outcomes. So, concern should be given in early detection and follow-up of patients who came late and older patients.

Surgical Management Outcome and Its Associated Factors Among Intestinal Obstruction Patients Admitted to Adult Surgical Ward of Wollega University Referral Hospital, Ethiopia

“…This study found that − 116 (59.2%) of patients managed for bowel obstruction had favorable management outcome. Although this result is comparable to the result of the study in Turkey (58.1%) [20], it is lower than the ndings of the study done in Nekemte specialized hospital-73.5% [10], Adama Hospital-75.4% [11], Asella hospital-75.7% [12], Adama Hospital-75.4% [11], Arba Minch General Hospital-77.7% [13], Chiro Hospital-78.7% [14], Dilla Hospital-86.4% [15], University of Gondar Comprehensive Specialized Hospital-83.3% [16], Debre Birhan Referral Hospital-83.3% [4], 82% in south Wollo Zone hospitals [17], 77% in Wolayita [18], Kenya-86.4% [26], and India-74% [27]. The possible reason for the observed discrepancy might be the difference in the way the management outcome was operationalized and measured, the difference in the professionals involved in the surgical management, the difference in the study settings, study period, and population.…”

“…In our study, favorable management outcome was affected by gangrenous intraoperative nding. This is supported by the study conducted in Wolayita [18], Asella hospital [12], Arba Minch General Hospital [13], Chiro, Dilla, and Adama hospitals in which patients with viable small bowel volvulus and viable sigmoid volvulus were more likely to have favorable surgical management outcome compared to their counterparts [11,14,15].…”

“…As of pocket studies conducted in different parts of Ethiopia, the prevalence of favorable outcome for bowel obstruction management ranges from 73.5%-86.4% [4,[10][11][12][13][14][15][16][17][18]. The incidence of intestinal obstruction and its surgical management outcome may be affected by different factors.…”

Mortality and Its Associated Factors of Bowel Obstruction after Surgical Treatment Among Adult Patients at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia 2021 (Retrospective Cross-Sectional Study)

“…as intra operative ndings of gangrenous small and large bowels, length of hospital stay, duration of illness before treatment, comorbidity, Hemoglobin, WBC, post & pre-operative complications and age was independent predicator of mortality for adult patients treated surgically.The odds of gangrenous large bowel obstructions to cause mortality after treated bowel obstruction surgically was 5.5 times higher than viable large bowel (AOR 5.58; 95%CI [2.33, 3.36), p=0.0001]. The odds old age (>=55) to cause mortality after treatment of bowel obstruction surgically was 3.7 times higher than compared with age groups(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) years old ((…”

Short-term outcomes of deeper intubation technique of ileus tube for different types of acute intestinal obstruction patients: A retrospective multicenter study

“…Intestinal obstruction is one of the most common reasons of all emergency department visits for acute abdominal pain ( 1 ). Serious complications such as septic shock, intestinal perforation, severe electrolyte disturbance, and multiple organ dysfunction syndrome may occur, which may lead to approximately 5%–10% death rate ( 14 ). The treatment strategies for acute intestinal obstruction are relatively complex, which could be mainly divided into surgery treatment and conservative treatment ( 3 , 15 ).…”