Paralytic ileus in the United States: A cross-sectional study from the national inpatient sample

Solanki, Shantanu; Chakinala, Raja Chandra; Haq, Khwaja F.; Singh, Jagmeet; Khan, Muhammad Ali; Solanki, Dhanshree; Vyas, Manasee; Kichloo, Asim; Mansuri, Uvesh; Shah, Harshil; Patel, Achint; Haq, Khwaja S.; Iqbal, Umair; Nabors, Christopher; Khan, Hafiz; Aronow, Wilbert S.

doi:10.1177/2050312120962636

Cited by 14 publications

(15 citation statements)

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“…It is a type of functional ileus characterized by decreased contractions of smooth muscles of the bowel wall [1,3,14,15]. Usually occurring after abdominal or retroperitoneal surgeries, it can also be due to medications (e.g., opioids or neuroleptics), metabolic disorders (e.g., electrolyte disturbances -hypokalemia, diabetes mellitus), or vascular injuries (e.g., hypoperfusion of the bowel) [1][2][3][4]16]. Unlike mechanical ileus where there is some form of physical obstruction, paralytic ileus is multifactorial, involving cytokines, neuropeptides, and nitric oxide leading to dysregulation of the sympathetic and parasympathetic control of the gut [1,3,14].…”

Section: Discussionmentioning

confidence: 99%

“…Paralytic ileus is a common condition in hospitalized patients with a mortality of up to 6% [ 1 , 4 ]. It is a type of functional ileus characterized by decreased contractions of smooth muscles of the bowel wall [ 1 , 3 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Paralytic ileus (PI) is common in critically ill patients after surgery due to an inflammatory response, electrolyte abnormalities, or medications [1][2][3]. It can lead to high morbidity and mortality if not acutely cared for, diagnosed early, and managed appropriately [1,[4][5][6]. Pancreaticobiliary diseases can also cause patients to become severely ill and ERCP has been the mainstay for treatment [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Exploring the Association Between Paralytic Ileus and Endoscopic Retrograde Cholangiopancreatography Complications Using the National Inpatient Sample Database

Wong¹,

Hashemipour²,

Manoharan³

et al. 2022

Cureus

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IntroductionParalytic ileus (PI) is often seen in critically ill hospitalized patients. Those with pancreaticobiliary diseases will require endoscopic retrograde cholangiopancreatography (ERCP) for management. Here, we will explore the association between patients with paralytic ileus who underwent ERCP and post-procedural complications, which has not been done before. MethodsPatients who underwent ERCP between 2007 and 2017 in the National Inpatient Sample database were selected. Cases were matched 1:1 by age, gender, race, and the Elixhauser comorbidity index for patients with and without pre-procedural paralytic ileus. Primary outcomes were associations between paralytic ileus and length of stay, payor status, and average total charges. Secondary outcomes were associations between paralytic ileus and post-ERCP complications (infection, pancreatitis, cholangitis, cholecystitis, perforation, hemorrhage), and overall mortality. The Chi-squared analysis was used to compare categorical data, and the independent t-test was used for continuous data. Regression analysis was used to assess primary and secondary outcomes. ResultsOf 2,008,217 hospitalized patients from 2007 to 2017, 43,643 patients had paralytic ileus and 43,859 patients did not, before undergoing ERCP. There were no differences in age, gender, race, or the Elixhauser comorbidity index. The differences in the length of stay, payor status, and total charges were significant (p<0.001). Patients with paralytic ileus had increased risks of post-ERCP infection, pancreatitis, cholangitis, cholecystitis, perforation, hemorrhage, and overall mortality (p<0.001). ConclusionsPatients hospitalized with paralytic ileus who underwent ERCP had a longer length of stay, higher total charges, and were less compensable. They also had increased risks for post-ERCP infection, pancreatitis, cholangitis, cholecystitis, perforation, hemorrhage, and overall mortality, which can be from critical illness and the systemic inflammatory response.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring the Association Between Paralytic Ileus and Endoscopic Retrograde Cholangiopancreatography Complications Using the National Inpatient Sample Database

Wong¹,

Hashemipour²,

Manoharan³

et al. 2022

Cureus

View full text Add to dashboard Cite

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“…We compared categorical variables by using Chi-squared (χ 2 ) test and continuous variables by Wilcoxon rank-sum test. These statistical methods have been used previously in multiple NIS based studies [18][19][20]. All the differences between the estimates are statistically significant (P < 0.05) unless otherwise specified.…”

Section: Data Source and Statistical Analysismentioning

confidence: 99%

Clostridium difficile Infection Hospitalizations in the United States: Insights From the 2017 National Inpatient Sample

et al. 2021

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Background: There is a paucity of contemporary national estimates for Clostridium difficile infection (CDI) hospitalizations by age group, sex, and region in the US population. Also, there is lack of contemporary national statistics on CDI hospitalizations with comorbidities. Methods:We analyzed the 2017 National Inpatient Sample (NIS) to determine the population-based rates of CDI hospitalizations, characteristics of hospitalizations with CDI, and the rates of comorbidities associated with CDI hospitalizations.Results: There were 329,460 CDI-related hospitalizations in 2017 (almost 1% of all hospitalizations). The average age for patients admitted with CDI as a principal or secondary diagnosis was 64.7 years (almost 20 years older when compared with all other hospitalizations). Patients 85 years and older had the highest rate of CDI hospitalizations (716 per 100,000 hospitalizations), and patients less than 18 years of age had the lowest rate (12 per 100,000 hospitalizations). There was a progressive increase in the CDI hospitalization rates with each successive age group. The hospitalization rates were higher in females (114 per 100,000 hospitalizations) than males (88 per 100,000 hospitalizations). The CDI hospitalization rate was highest in the Northeast (109 per 100,000 hospitalizations) and lowest in the West (84 per 100,000 hospitalizations). Fluid and electrolyte disturbance (63.3%) and renal failure (33.4%) were the two most common comorbidities associated with CDI hospitalizations. When CDI is a secondary diagnosis, major loss of function, extreme likelihood of dying, septicemia, and septic shock were more common in comparison to CDI as a principal diagnosis.Conclusions: CDI hospitalization rates were highest in the elderly over 85 years old and declined with successive decreases in age. Women had higher CDI hospitalization rates than men, and fluid and electrolyte disturbances and renal failure were the most common comorbid conditions. The presence of CDI as a comorbid condition at the time of hospitalization for other principal diagnoses or development of CDI during a hospitalization for other principal diagnoses significantly increases the risk of in-hospital morbidity and mortality.

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“…The costs associated with POI are considerable. In the USA, the annual total care costs for all paralytic ileus hospitalisations increased from 7.1 billion dollars in 2001 to 12.3 billion dollars in 2011 (Solanki et al, 2020). This review addresses current knowledge on mechanisms responsible for POI and the pharmacological strategies currently employed or under development to prevent or reduce POI.…”

Section: Introductionmentioning

confidence: 99%

Post-Operative Ileus: a Pharmacological Perspective

Buscail¹,

Deraison

2021

Preprint

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Post-operative ileus (POI) is a frequent complication after abdominal surgery. The consequences of POI can be potentially serious such as bronchial inhalation or acute functional renal failure. Numerous advances in peri-operative management, particularly early rehabilitation, have made it possible to decrease POI. Despite this, the rate of prolonged POI ileus remains high and can be as high as 25% of patients in colorectal surgery. From a pathophysiological point of view, POI has two phases, an early neurological phase and a later inflammatory phase, to which we could add a “pharmacological” phase during which analgesic drugs, particularly opiates, play a central role. The aim of this review article is to describe the phases of the pathophysiology of POI, to analyse the pharmacological treatments currently available through published clinical trials and finally to discuss the different research areas for potential pharmacological targets.

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Paralytic ileus in the United States: A cross-sectional study from the national inpatient sample

Cited by 14 publications

References 45 publications

Exploring the Association Between Paralytic Ileus and Endoscopic Retrograde Cholangiopancreatography Complications Using the National Inpatient Sample Database

Exploring the Association Between Paralytic Ileus and Endoscopic Retrograde Cholangiopancreatography Complications Using the National Inpatient Sample Database

Clostridium difficile Infection Hospitalizations in the United States: Insights From the 2017 National Inpatient Sample

Post-Operative Ileus: a Pharmacological Perspective

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