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.
Il testo completo di questo articolo è disponibile in 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. |
Riassunto |
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.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Low osmolar water soluble contrast, Adhesive small bowel obstruction, Non-operative management
Mappa
| ☆ | 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 - aprile 2019 Ritorno al numero
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