Implementation of an adhesive small bowel obstruction protocol using low-osmolar water soluble contrast and the impact on patient outcomes. Am J Surg 2019 Apr;217(4):689-693
Date
09/15/2018Pubmed ID
30213382DOI
10.1016/j.amjsurg.2018.08.003Scopus ID
2-s2.0-85063114597 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
BACKGROUND: Small bowel obstruction (SBO) is a common condition leading to numerous hospital admissions and operations. Standardized care of adhesive SBO patients has not been widely implemented in hospital systems.
METHODS: A prospective cohort of SBO patients was compared to a historical cohort of SBO patients after implementation of a SBO protocol using evidence-based guidelines and Omnipaque, a low-osmolar water soluble contrast. Patients without a history of abdominal surgery were excluded and data was collected through chart review.
RESULTS: Univariate analyses demonstrated a decrease in both LOS by 1.35 days and in the proportion of patients receiving surgery (37% vs 25%; p < 0.05). There was a decrease in time to surgery, rate of SBR, and rate of complications, yet an increase in readmission, although these findings were not statistically significant.
CONCLUSIONS: Utilizing an evidence-based SBO protocol can lead to shorter LOS and may result in fewer operations for adhesive SBO patients.
Author List
Trevino CM, VandeWater T, Webb TPAuthor
Colleen Trevino PhD Associate Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedClinical Protocols
Contrast Media
Female
Humans
Intestinal Obstruction
Intestine, Small
Iohexol
Length of Stay
Male
Middle Aged
Osmolar Concentration
Prospective Studies
Tissue Adhesions