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. [doi:10.1016/j.amjsurg.2022.04.019] [http://hdl.handle.net/10807/211590]

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

Quero, Giuseppe
Writing – Original Draft Preparation
;
De Sio, Davide
Writing – Review & Editing
;
Covino, Marcello
Writing – Original Draft Preparation
;
Fiorillo, Claudio
Writing – Review & Editing
;
Laterza, Vito
Writing – Original Draft Preparation
;
Schena, Carlo Alberto
Visualization
;
Rosa, Fausto
Data Curation
;
Menghi, Roberta
Writing – Review & Editing
;
Carbone, Luigi
Visualization
;
Piccioni, Andrea
Resources
;
Franceschi, Francesco
Supervision
;
Alfieri, Sergio
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.
2022
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, <<THE AMERICAN JOURNAL OF SURGERY>>, 2022; (019): 1-6. [doi:10.1016/j.amjsurg.2022.04.019] [http://hdl.handle.net/10807/211590]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/211590
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 7
  • ???jsp.display-item.citation.isi??? 3
social impact