Abstract
Background Intestinal obstruction (IO) is one of the most common acute abdominal disorders that often requires emergency surgical management in the hospital setting. However, the surgical management sometimes ends with unfavorable outcomes characterized by fatal and nonfatal postoperative complications. Aim The aim of this study was to analyze the surgical management outcome of IO and its associated factors among surgically treated patients for intestinal obstruction at the University of Gondar Comprehensive Specialized Hospital (UGCSH), Ethiopia, 2018. Methods An institution-based cross-sectional study was conducted among patients who were surgically treated for IO during the last 3 years at the UGCSH. The patient participants were selected using a systematic random sampling technique. A structured research tool was used to collect all the necessary data from the patients' medical records. The data were analyzed by using SPSS version 21. Frequencies with percentages were used to describe the surgical management outcome of IO. The binary logistic regression model was used to explore the determinant factors associated with the surgical management outcome of IO. Factors at P < 0.05 were declared statically significant. Results 227 patient participants were included and finally analyzed in this study. From these, 83.3% patients have favorable surgical management outcomes of IO, whereas the rest 16.7% patients have unfavorable outcomes. Of 38 patients with unfavorable outcome, the most common postoperative complication occurred was surgical site infection (36.8%), followed by pneumonia (23.6%) and septic shock (21.0%) among other complications. A total of 10 postoperative deaths were also documented as unfavorable surgical management outcomes of IO. Of the determinant factors analyzed in this study, only three factors, duration of illness before surgery, length of hospital stay after surgery, and comorbidity, were independently significantly associated with the surgical management outcome of IO. Conclusions In this study, the majority of patients had favorable surgical management outcomes of IO, and the proportion of patients with unfavorable outcomes was however considerable. Thus, designing a strategy addressing the significantly associated determining factors could be helpful to further increase the likelihood of favorable surgical management outcomes of IO.
Highlights
Intestinal obstruction (IO) is a potentially risky surgical emergency associated with high morbidity and mortality rates in both developed and developing world [1, 2]
Based on the anatomical location, IO is mainly classified as small bowel obstruction (SBO) and large bowel obstruction (LBO) [2]; it can be either mechanical or functional on the basis of the underlying pathophysiology of obstruction [11]. e etiology of IO has been varied with SBO caused by adhesions, strangulated hernia, malignancy, and volvulus [2]. e causes of IO vary in different populations and areas. e most frequent causes of IO in the developing region are likely hernia and volvulus, whereas adhesions are most frequent in the developed region
Study Area and Setting. is study was conducted at the University of Gondar Comprehensive Specialized Hospital (UGCSH), which is located in Gondar city, northwestern Ethiopia
Summary
Intestinal obstruction (IO) is a potentially risky surgical emergency associated with high morbidity and mortality rates in both developed and developing world [1, 2] It causes significant surgical side effects in hospital admissions and adversely affects the life of millions of people, cutting across all age groups, with considerable direct and indirect economic impacts on the healthcare system and the affected patients [3]. E incidence of IO is recognized to be high in India, Iran, Afghanistan, and certain African countries including Ethiopia It has been the leading cause of acute abdominal disorders in Africa [4,5,6,7]. Aim. e aim of this study was to analyze the surgical management outcome of IO and its associated factors among surgically treated patients for intestinal obstruction at the University of Gondar Comprehensive Specialized Hospital (UGCSH), Ethiopia, 2018. The majority of patients had favorable surgical management outcomes of IO, and the proportion of patients with unfavorable outcomes was considerable. us, designing a strategy addressing the significantly associated determining factors could be helpful to further increase the likelihood of favorable surgical management outcomes of IO
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