TY - JOUR

T1 - Management and short-term outcomes of patients with small bowel obstruction in Denmark

T2 - a multicentre prospective cohort study

AU - Olausson, M.

AU - Aerenlund, M. P.

AU - Azzam, M.

AU - Bjerke, T.

AU - Burcharth, J. F.H.

AU - Dibbern, C. B.

AU - Jensen, T. K.

AU - Jordhøj, J. Q.

AU - Lolle, I.

AU - Ngo-Stuyt, L.

AU - Nielsen, E.Ø.

AU - Nielsen, L. B. J.

AU - Skovsen, A. P.

AU - Tolver, M. A.

AU - Smith, H. G.

N1 - Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

PY - 2023

Y1 - 2023

N2 - Aims: The optimal management of small bowel obstruction (SBO) remains a matter of debate and treatment varies internationally. In Denmark, a more surgically aggressive strategy has traditionally been used, but to what extent patient outcomes differ from international reports is unknown. This study aimed to describe the current management and outcomes of patients admitted with SBO in Denmark. Methods: This was a prospective cohort study conducted at six acute hospitals in Denmark over a 4-month period. Patients aged ≥ 18 years with a clinical or radiological diagnosis of SBO were eligible. Primary outcomes were 30 day morbidity and mortality rates. Results: 316 patients were included during the study period. The median age was 72 years and 56% were female. Diagnosis was made by computed tomography (CT) in 313 patients (99.1%), with the remaining three diagnosed clinically. Non-operative management was the initial strategy in 152 patients (48.1%) and successful in 119 (78.3%). Urgent surgery was performed in the remaining 164 (51.9%), with a laparoscopic approach used in 84 patients (51.2%). The entire cohort had a 30 day mortality rate of 7.3% and a 30 day morbidity rate of 17.1%. Conclusions: The management of SBO in Denmark differs markedly to previous international reports, with an almost ubiquitous use of CT for diagnosis and a high proportion of patients undergoing urgent surgery. Despite higher rates of surgery, patient outcomes are broadly similar to reports of more conservative strategies, perhaps due to a reduction in delayed operations. Trial registration: Trial registration number: NCT04750811. Trial registration date: 11/02/2021.

AB - Aims: The optimal management of small bowel obstruction (SBO) remains a matter of debate and treatment varies internationally. In Denmark, a more surgically aggressive strategy has traditionally been used, but to what extent patient outcomes differ from international reports is unknown. This study aimed to describe the current management and outcomes of patients admitted with SBO in Denmark. Methods: This was a prospective cohort study conducted at six acute hospitals in Denmark over a 4-month period. Patients aged ≥ 18 years with a clinical or radiological diagnosis of SBO were eligible. Primary outcomes were 30 day morbidity and mortality rates. Results: 316 patients were included during the study period. The median age was 72 years and 56% were female. Diagnosis was made by computed tomography (CT) in 313 patients (99.1%), with the remaining three diagnosed clinically. Non-operative management was the initial strategy in 152 patients (48.1%) and successful in 119 (78.3%). Urgent surgery was performed in the remaining 164 (51.9%), with a laparoscopic approach used in 84 patients (51.2%). The entire cohort had a 30 day mortality rate of 7.3% and a 30 day morbidity rate of 17.1%. Conclusions: The management of SBO in Denmark differs markedly to previous international reports, with an almost ubiquitous use of CT for diagnosis and a high proportion of patients undergoing urgent surgery. Despite higher rates of surgery, patient outcomes are broadly similar to reports of more conservative strategies, perhaps due to a reduction in delayed operations. Trial registration: Trial registration number: NCT04750811. Trial registration date: 11/02/2021.

KW - Emergency general surgery

KW - Peri-operative outcomes

KW - Small bowel obstruction

U2 - 10.1007/s00068-022-02171-y

DO - 10.1007/s00068-022-02171-y

M3 - Journal article

C2 - 36357790

AN - SCOPUS:85141736127

VL - 49

SP - 1121

EP - 1130

JO - European Journal of Trauma and Emergency Surgery

JF - European Journal of Trauma and Emergency Surgery

SN - 1863-9933

ER -