National Audit of Small Bowel Obstruction Steering Group and Nat; NASBO Steering Group; NASBO Collaborators; West Midlands Research Collaborative
(2020)
Outcomes of obstructed abdominal wall hernia: results from the UK national small bowel obstruction audit.
BJS Open, 4 (5).
pp. 924-934.
ISSN 2474-9842
https://doi.org/10.1002/bjs5.50315
SGUL Authors: Azhar, Bilal
Abstract
BACKGROUND: Abdominal wall hernia is a common surgical condition. Patients may present in an emergency with bowel obstruction, incarceration or strangulation. Small bowel obstruction (SBO) is a serious surgical condition associated with significant morbidity. The aim of this study was to describe current management and outcomes of patients with obstructed hernia in the UK as identified in the National Audit of Small Bowel Obstruction (NASBO). METHODS: NASBO collated data on adults treated for SBO at 131 UK hospitals between January and March 2017. Those with obstruction due to abdominal wall hernia were included in this study. Demographics, co-morbidity, imaging, operative treatment, and in-hospital outcomes were recorded. Modelling for factors associated with mortality and complications was undertaken using Cox proportional hazards and multivariable regression modelling. RESULTS: NASBO included 2341 patients, of whom 415 (17·7 per cent) had SBO due to hernia. Surgery was performed in 312 (75·2 per cent) of the 415 patients; small bowel resection was required in 198 (63·5 per cent) of these operations. Non-operative management was reported in 35 (54 per cent) of 65 patients with a parastomal hernia and in 34 (32·1 per cent) of 106 patients with an incisional hernia. The in-hospital mortality rate was 9·4 per cent (39 of 415), and was highest in patients with a groin hernia (11·1 per cent, 17 of 153). Complications were common, including lower respiratory tract infection in 16·3 per cent of patients with a groin hernia. Increased age was associated with an increased risk of death (hazard ratio 1·05, 95 per cent c.i. 1·01 to 1·10; P = 0·009) and complications (odds ratio 1·05, 95 per cent c.i. 1·02 to 1·09; P = 0·001). CONCLUSION: NASBO has highlighted poor outcomes for patients with SBO due to hernia, highlighting the need for quality improvement initiatives in this group.
Item Type: |
Article
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Additional Information: |
© 2020 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of British Journal of Surgery Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by/4.0/), which permits non-commercial reuse, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
Keywords: |
Adult, Aged, Aged, 80 and over, Emergency Treatment, Female, Hernia, Abdominal, Hospital Mortality, Humans, Intestinal Obstruction, Logistic Models, Male, Middle Aged, Postoperative Complications, Proportional Hazards Models, Quality Improvement, United Kingdom, National Audit of Small Bowel Obstruction Steering Group and National Audit of Small Bowel Obstruction Collaborators, NASBO Steering Group, NASBO Collaborators, West Midlands Research Collaborative, Humans, Hernia, Abdominal, Intestinal Obstruction, Postoperative Complications, Emergency Treatment, Hospital Mortality, Logistic Models, Proportional Hazards Models, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Male, Quality Improvement, United Kingdom |
Journal or Publication Title: |
BJS Open |
ISSN: |
2474-9842 |
Language: |
eng |
Dates: |
Date | Event |
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October 2020 | Published | 10 July 2020 | Published Online | 26 May 2020 | Accepted |
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Publisher License: |
Creative Commons: Attribution 4.0 |
Projects: |
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PubMed ID: |
32648645 |
Web of Science ID: |
WOS:000547922100001 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/116371 |
Publisher's version: |
https://doi.org/10.1002/bjs5.50315 |
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