Background: Few evidences are available on adhesive bowel obstruction (ASBO)management and outcomes in geriatric patients. Methods: One-hundred-twenty-eight patients aged 65–79 years were retrospectively compared to 77 patients aged ≥80 years. Aim of this study was to compare ASBO management and in-hospital course between patients aged 65–79 years and those over 80 years. Results: Upfront surgery in octogenarians related with a higher rate of major complications (23.7%vs4.9%; p = 0.009) and longer hospitalization (8.8vs7.3 days; p = 0.01). No difference according to age was noted in terms of clinical outcomes when the non-operative management (NOM) was employed. Patients aged ≥80 years managed conservatively presented shorter hospitalization (7.3vs8.8 days; p = 0.04), lower rate of intensive care unit (ICU) admission (0vs18.4%; p = 0.005) and cumulative major complications (2.6%vs23.7%; p = 0.007) as compared to ≥80 years old patients treated with upfront surgery. In this same group, NOM failure did not lead to worse outcomes in comparison to upfront surgery. Conclusions: NOM in≥80 years patients is associated with better in-hospital course. The acceptable clinical outcomes in case of NOM failure further support NOM as first treatment strategy to employ in this same subset of patients.

Quero, G., De Sio, D., Covino, M., Fiorillo, C., Laterza, V., Schena, C. A., Rosa, F., Menghi, R., Carbone, L., Piccioni, A., Franceschi, F., Alfieri, S., Adhesive small bowel obstruction in octogenarians: A 6-year retrospective single-center analysis of clinical management and outcomes, <<THE AMERICAN JOURNAL OF SURGERY>>, 2022; (019): 1-6 [http://hdl.handle.net/10807/211590]

Adhesive small bowel obstruction in octogenarians: A 6-year retrospective single-center analysis of clinical management and outcomes

Giuseppe Quero
Writing – Original Draft Preparation
;
Davide De Sio
Writing – Review & Editing
;
Marcello Covino
Writing – Original Draft Preparation
;
Claudio Fiorillo
Writing – Review & Editing
;
Vito Laterza
Writing – Original Draft Preparation
;
Carlo Alberto Schena
Visualization
;
Fausto Rosa
Data Curation
;
Roberta Menghi
Writing – Review & Editing
;
Luigi Carbone
Visualization
;
Andrea Piccioni
Resources
;
Francesco Franceschi
Supervision
;
Sergio Alfieri
Supervision
2022

Abstract

Background: Few evidences are available on adhesive bowel obstruction (ASBO)management and outcomes in geriatric patients. Methods: One-hundred-twenty-eight patients aged 65–79 years were retrospectively compared to 77 patients aged ≥80 years. Aim of this study was to compare ASBO management and in-hospital course between patients aged 65–79 years and those over 80 years. Results: Upfront surgery in octogenarians related with a higher rate of major complications (23.7%vs4.9%; p = 0.009) and longer hospitalization (8.8vs7.3 days; p = 0.01). No difference according to age was noted in terms of clinical outcomes when the non-operative management (NOM) was employed. Patients aged ≥80 years managed conservatively presented shorter hospitalization (7.3vs8.8 days; p = 0.04), lower rate of intensive care unit (ICU) admission (0vs18.4%; p = 0.005) and cumulative major complications (2.6%vs23.7%; p = 0.007) as compared to ≥80 years old patients treated with upfront surgery. In this same group, NOM failure did not lead to worse outcomes in comparison to upfront surgery. Conclusions: NOM in≥80 years patients is associated with better in-hospital course. The acceptable clinical outcomes in case of NOM failure further support NOM as first treatment strategy to employ in this same subset of patients.
Inglese
Quero, G., De Sio, D., Covino, M., Fiorillo, C., Laterza, V., Schena, C. A., Rosa, F., Menghi, R., Carbone, L., Piccioni, A., Franceschi, F., Alfieri, S., Adhesive small bowel obstruction in octogenarians: A 6-year retrospective single-center analysis of clinical management and outcomes, <>, 2022; (019): 1-6 [http://hdl.handle.net/10807/211590]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/211590
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