Implementation of an adhesive small bowel obstruction protocol using low-osmolar water soluble contrast and the impact on patient outcomes - 14/03/19
, Tracy VandeWater , Travis P. Webb Abstract |
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.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Standardization of SBO management is improved with an institutional protocol. |
• | LOS is reduced with a standardized low-osmolar water soluble contrast SBO protocol. |
• | A low-osmolar water soluble contrast SBO protocol does not increase complications. |
Résumé |
The new Adhesive SBO protocol was completed in most patients admitted to the Acute Care Surgery service with a diagnosis of SBO standardizing care utilizing an evidence-based protocol with low-osmolar water soluble contrast. 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.
Le texte complet de cet article est disponible en PDF.Keywords : Low osmolar water soluble contrast, Adhesive small bowel obstruction, Non-operative management
Plan
| ☆ | Presented as an e-poster at the American College of Surgeons Clinical Congress 2017 October 22–26, in San Diego, CA. |
Vol 217 - N° 4
P. 689-693 - avril 2019 Retour au numéro
Article précédent
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