Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

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Analysis of Related Factors in Elderly Patients with Strangulated Small Bowel Obstruction

TIAN Jing1,2, GUAN Wenxian1, HE Jian3, ZHOU Zhuping 3 , FENG Min1, WANG Hao1, WANG Jun2   

  1. 1Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China;
    2Department of Emergency, 3Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
  • Received:2017-07-18 Online:2018-05-03 Published:2018-05-03
  • Contact: GUAN Wenxian Tel:025-68182098, Fax:025-68182097,E-mail:guan-wx@163.com
  • Supported by:
    Supported by the National Key R&D Program of China(2016YFC0104105)

Abstract: Objective To investigate the surgery-related factors of strangulated small bowel obstruction in the elderly patients. Methods The clinical data of 261 elderly patients with acute small bowel obstruction treated between July 2010 and September 2016 were analyzed retrospectively. Differences of clinical data, laboratory results, and CT findings were compared between the elderly strangulation group(ESt group,n=139)and the elderly simple group (ESi group,n=122). The surgery-related factors of strangulated small bowel obstruction in the elderly were analyzed by univariate and multivariate Logistic regression analysis. Results The ESt group and the ESi group showed significant differences in factors including muscle guarding (χ2=102.331,P=0.000), ASA score≥3 (χ2=69.748, P=0.000), leukocyte count (t=7.453, P=0.000), C-reactive protein (t =2.128, P=0.034), segmental mesenteric fluid (χ2=78.655, P=0.000), thick-walled small bowel (χ2=100.806, P=0.000), intestinal wall of hyperattenuation (χ2=69.068, P=0.000), ascites (χ2=89.299, P=0.000), mesenteric fat stranding (χ2=80.255, P=0.000), bird’s beak sign (χ2=84.451, P=0.000), and stranding sign (χ2=98.635, P=0.000). Univariate regression analysis indicated the above 11 factors were the surgery-related factors in elderly patients with strangulated small bowel obstruction. Multivariate Logistic regression analysis showed that the surgery-related factors included segmental mesenteric fluid (OR=3.576, 95%CI: 1.043 - 12.261, P=0.043), ASA score≥3 (OR =3.463, 95%CI: 1.149 - 10.441, P=0.027), muscle guarding (OR =3.288, 95%CI: 1.010 - 10.707, P=0.048), thick-walled small bowel (OR =3.046, 95%CI: 1.074 - 8.638,P=0.036), and increased leukocyte count (OR =1.307, 95%CI: 1.170 - 1.458, P=0.000). Conclusions Muscle guarding, ASA score≧3, segmental mesenteric fluid, thick-walled small bowel, and increased leukocyte count are the surgery-related factors of strangulated small bowel obstruction in the elderly patients.

Key words: acute small bowel obstruction, strangulated small bowel obstruction, surgery-related factors, the elderly

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