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Analysis of predictive factors requiring early surgical interventions in small bowel obstruction.

Purpose
Small bowel obstruction (SBO) is a common disease that requires hospitalization. The most common cause of SBO is postoperative adhesion. Delayed timing of operation in patients who need surgical intervention results in severe mortality and morbidity. A number of studies have been conducted on SBO and some criteria have been established for emergency surgery. However, only few objective clinical parameters are available for screening patients who need delayed operation. Therefore, we analyzed factors that affect the clinical course of SBO to select an appropriate therapeutic plan for reducing the risk of complications in these patients.


Methods
We investigated the clinical characteristics of patients admitted to the department of surgery of our hospital between January 1, 2015, and December 31, 2016, who were diagnosed as having SBO. The patients were divided into an operative treatment group (n = 12) and a conservative treatment group (n = 96). We compared clinical characteristics between the two groups.


Results
The operative treatment group underwent more operations before SBO than the conservative treatment group (p = 0.007). Moreover, the initial leukocyte count and C-reactive protein (CRP) level were elevated in the operative group (p = 0.004 and p = 0.028 respectively). Body mass index (BMI) were lower in the operative group (p = 0.013).


Conclusion
The number of operations before SBO, leukocyte count, CRP level, and BMI were useful parameters for selecting patients who need urgent operation for SBO.