Homecho Primary Hospital, Gibe District, Southern Ethiopia, Ethiopia.
College of Medicine and Health Sciences, School of Medicine, Wolayita Sodo University, Wolayita Sodo, Ethiopia.
BMC Surg. 2022 Mar 30;22(1):121. doi: 10.1186/s12893-022-01568-1.
Procedures to treat intestinal obstruction range from minimally invasive laparoscopic surgery to more complicated open surgical procedures. It may end with high morbidity and mortality because of different reasons. It is very important to know about the determinants of favorable outcome of surgical management for intestinal obstruction however, little is known about this problem at public hospitals of Southern Ethiopia.
Facility based cross sectional study was conducted. A total of 230 medical records which fulfill the inclusion criteria were used for this study. Variables with p value of less than 0.25 in the bivariate analysis were entered in multivariable logistic regression to control confounding. Finally, odds ratio with 95% confidence interval was used to identify variables which were significantly associated with dependent variable.
According to this study the magnitude of favorable surgical management outcome of intestinal obstruction was 177(77.0%) [95% CI, 71.4, 82.4]. Having small bowel obstruction (AOR = 2.49) [95% CI 1.91, 5.12], having simple bowel obstruction (AOR = 4.32) [95% CI, 2.00, 9.35], early presentation of patients (AOR = 4.44) [95% CI, 1.99, 9.92] and intraoperative procedure other than resection and anastomosis was performed (AOR = 0.45) [95% CI, 0.21, 0.96] were significantly associated with favorable outcome among surgically treated patients.
The overall magnitude of favorable surgical management outcome of intestinal obstruction was moderate compared to other study. Having small bowel obstruction, having simple bowel obstruction, other procedure other than resection and anastomosis done, and early presentation of patients were significant predictors. Physicians should diagnose intestinal obstruction early and appropriate interventions should be taken on time before the complication happened. On time consultation and decision at the hospital setting is also recommended.
治疗肠梗阻的方法范围从微创腹腔镜手术到更复杂的开放式手术。由于不同的原因,它可能会导致高发病率和死亡率。然而,在埃塞俄比亚南部的公立医院,对于了解影响肠梗阻手术治疗结局的决定因素非常重要,但对这个问题知之甚少。
本研究采用基于设施的横断面研究。共有 230 份符合纳入标准的病历用于本研究。在双变量分析中 p 值小于 0.25 的变量被纳入多变量逻辑回归以控制混杂因素。最后,使用比值比及其 95%置信区间来确定与因变量显著相关的变量。
根据这项研究,肠梗阻手术治疗结局良好的比例为 177(77.0%)[95%置信区间,71.4,82.4]。患有小肠梗阻(AOR=2.49)[95%CI 1.91,5.12]、单纯性肠梗阻(AOR=4.32)[95%CI,2.00,9.35]、患者早期就诊(AOR=4.44)[95%CI,1.99,9.92]和术中除切除和吻合术以外的其他手术方式(AOR=0.45)[95%CI,0.21,0.96]与手术治疗患者的良好结局显著相关。
与其他研究相比,肠梗阻手术治疗结局良好的总体比例中等。患有小肠梗阻、单纯性肠梗阻、除切除和吻合术以外的其他手术方式、以及患者早期就诊是显著的预测因素。医生应尽早诊断肠梗阻,并在并发症发生前及时采取适当的干预措施。还建议在医院环境中及时咨询和决策。