Risk Factors of Early Postoperative Bowel Obstruction for Patients Undergoing Selective Colorectal Surgeries

Abstract

Objective: Postoperative bowel obstruction was one of the most severe complications in patients received colorectal surgeries. The aim of this study was to explore risk factors of early postoperative obstruction and to construct a nomogram to predict the possibility of occurrence. Methods: The records of 1437 patients who underwent selective colorectal surgery in Peking University People’s Hospital from 2015 to 2020 was retrospectively collect. Risk factors of early postoperative bowel obstruction were identified by logistic regression analysis and a nomogram was then constructed. Bootstrap was applied to verify the stability of the model. Results: COPD, hypothyroidism, probiotic indications, duration of antibiotics, and time to postoperative feeding were identified as independent risk factors and were put into a nomogram for predicting early postoperative bowel obstruction. The nomogram showed a robust discrimination, with area under the receiver operating characteristic curve was 0.894 and was well calibrated. Conclusion: A nomogram including independent risk factors of COPD, hypothyroidism, probiotic indications, duration of antibiotics, and time to postoperative feeding were established to predict the risk of early postoperative bowel obstruction.

Initial approach to the patient with abdominal pain

“…In patients with history of abdominal surgery, it is recommended to rule out intestinal obstruction in case of presentation to the emergency room with abdominal pain. Yang et al reported several independent risk factors for early postoperative intestinal obstruction, respectively chronic obstructive pulmonary disease (COPD), hypothyroidism, duration of antibiotics therapy, and duration of postoperative feeding [21]. The use of drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of peptic ulcer, while the use of corticosteroids may mask some symptoms [22,23].…”