skip to main content
Language:
Search Limited to: Search Limited to: Resource type Show Results with: Show Results with: Search type Index

Malnutrition, nutritional interventions and clinical outcomes of patients with acute small bowel obstruction: results from a national, multicentre, prospective audit

BMJ open, 2019-07, Vol.9 (7), p.e029235-e029235 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. ;2019 Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2019 ;ISSN: 2044-6055 ;EISSN: 2044-6055 ;DOI: 10.1136/bmjopen-2019-029235 ;PMID: 31352419

Full text available

Citations Cited by
  • Title:
    Malnutrition, nutritional interventions and clinical outcomes of patients with acute small bowel obstruction: results from a national, multicentre, prospective audit
  • Author: Lee, Matthew James ; Sayers, Adele E ; Drake, Thomas M ; Singh, Pritam ; Bradburn, Mike ; Wilson, Timothy R ; Murugananthan, Aravinth ; Walsh, Ciaran J ; Fearnhead, Nicola S
  • Subjects: Acute Disease ; Aged ; Aged, 80 and over ; Audits ; Bowel disease ; Clinical Audit ; Comorbidity ; Critical care ; Data collection ; Enteral nutrition ; Female ; Hospital Mortality ; Hospitals ; Humans ; Intensive care ; Intestinal Obstruction - complications ; Intestine, Small ; Male ; Malnutrition ; Malnutrition - etiology ; Malnutrition - mortality ; Malnutrition - therapy ; Middle Aged ; Nutrition ; Nutritional Status ; Parenteral Nutrition ; Patients ; Prospective Studies ; Surgery ; Systematic review
  • Is Part Of: BMJ open, 2019-07, Vol.9 (7), p.e029235-e029235
  • Description: ObjectiveThe aim of this study was to assess the nutritional status of patients presenting with small bowel obstruction (SBO), along with associated nutritional interventions and clinical outcomes.DesignProspective cohort study.Setting131 UK hospitals with acute surgical services.Participants2069 adult patients with a diagnosis of SBO were included in this study. The mean age was 67.0 years and 54.7% were female.Primary and secondary outcome measuresPrimary outcome was in-hospital mortality. Secondary outcomes recorded included: major complications (composite of in-hospital mortality, reoperation, unplanned intensive care admission and 30-day readmission), complications arising from surgery (anastomotic leak, wound dehiscence), infection (pneumonia, surgical site infection, intra-abdominal infection, urinary tract infection, venous catheter infection), cardiac complications, venous thromboembolism and delirium.ResultsPostoperative adhesions were the most common cause of SBO (49.1%). Early surgery (<24 hours postadmission) took place in 30.0% of patients, 22.0% underwent delayed operation and 47.9% were managed non-operatively. Malnutrition as stratified by Nutritional Risk Index was common, with 35.7% at moderate risk and 5.7% at severe risk of malnutrition. Dietitian review occurred in just 36.4% and 55.9% of the moderate and severe risk groups. In the low risk group, 30.3% received nutritional intervention compared with 40.7% in moderate risk group and 62.7% in severe risk group. In comparison to the low risk group, patients who were at severe or moderate risk of malnutrition had 4.2 and 2.4 times higher unadjusted risk of in-hospital mortality, respectively. Propensity-matched analysis found no difference in outcomes based on use or timing of parenteral nutrition.ConclusionsMalnutrition on admission is associated with worse outcomes in patients with SBO, and marked variation in management of malnutrition was observed. Future trials should focus on identifying effective and cost-effective nutritional interventions in SBO.
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 2044-6055
    EISSN: 2044-6055
    DOI: 10.1136/bmjopen-2019-029235
    PMID: 31352419
  • Source: ProQuest One Psychology
    BMJ Open Access Journals
    GFMER Free Medical Journals
    MEDLINE
    PubMed Central
    ROAD: Directory of Open Access Scholarly Resources
    ProQuest Central
    DOAJ Directory of Open Access Journals
Back to results list
INSPIRE LIBRARY - TON DUC THANG UNIVERSITY (84-028) 37 755 057 Feedback
19 Nguyen Huu Tho St. Dist.7, HCM thuvien@tdtu.edu.vn

Copyright © 2017 INSPIRE LIBRARY - TON DUC THANG UNIVERSITY

Searching Remote Databases, Please Wait