1. Outcomes of obstructed abdominal wall hernia: results from the UK national small bowel obstruction audit
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Lee, MJ, Drake, TM, Sayers, AE, Walsh, CJ, Davies, MM, Fearnhead, NS, Abercrombie, J, Acheson, A, Alderson, D, Anderson, I, Bach, S, Davies, M, Hamady, Z, Hind, D, Hollyman, M, Hare, S, Lee, E, Northover, J, Lewis, C, Marriott, P, Maynard, N, Murray, D, Tierney, G, Verjee, A, Wild, J, Abbott, S, Abdulaal, Y, Afshar, S, Ah‐Chuen, J, Ahmed, T, Akhtar, M, Akram, F, Aldred, E, Ali, A, Aly, M, Amajuoyi, A, Amin, V, Anderson, D, Anderson, O, Andreou, A, Ansari, A, Appleton, S, Ardley, R, Arshad, F, Ashour, O, Asour, A, Athem, A, Athersmith, M, Ayoub, F, Azeem, H, Azhar, B, Badenoch, T, Baillie, C, Bandyopadhyay, D, Barker, J, Barker, S, Barkham, B, Baron, R, Barrie, J, Barry‐Yarrow, E, Bashir, G, Battersby, N, Bazoua, G, Behar, N, Bellam, S, Berger, C, Bhandari, S, Bhasin, S, Biggs, S, Bisset, C, Blake, L, Blencowe, N, Boam, T, Boddy, A, Boereboom, C, Bogdan, M, Bogle, R, Bohra, P, Boland, M, Bolkan, H, Borg, C, Boulton, R, Bouras, G, Boyer, M, Boyle, J, Branagan, G, Brewer, H, Briggs, C, Broadhurst, J, Brown, E, Brown, J, Brown, L, Brown, O, Burns, K, Butcher, K, Butler, M, Byrne, B, Campbell, L, Capper, C, Cartmell, M, Cash, T, Chan, S, Chandratreya, N, Chapman, J, Chapman, S, Charalabopoulos, A, Cheek, C, Chok, S, Choong, W, Chow, M, Chowdhury, J, Coe, P, Conaghan, P, Conn, G, Cook, N, Cook, T, Cooper, S, Cornish, J, Cotton, D, Cox, C, Coyne, P, Crook, R, Crozier, J, Cuffolo, G, Cunha, P, Curtis, N, Cutting, J, Da Costa, K, Silva, L, Das, B, Davenport, M, Davies, J, Davies, T, Day, A, Dayal, S, Dean, S, Demetriou, G, Dengu, F, Dennis, R, Dent, H, Dent, P, Deputy, M, Devoto, L, Di Benedetto, G, Dindyal, S, Donnelly, E, Doody, P, Douka, E, Downham, C, Dowson, H, Edent, H, Edgerton, K, Ekpete, N, El Farran, M, Elamin, O, Eljaafari, M, Elsaid, N, El‐Sharif, M, Evans, J, Evans, M, Ewe, R, Ewing, A, Exarchou, K, Fallaize, R, Faoury, M, Farag, S, Farinella, E, Faulkner, G, Ferguson, H, Fisher, O, Fletcher, J, Forouzanfar, A, Foster, A, Fox, R, Francis, N, Fretwell, V, Fung, D, Gammeri, E, Garnham, J, Geraghty, A, Gilbert, A, Gill, C, Gill, M, Gillespie, M, Giordano, P, Glasbey, J, Goh, M, Golder, A, Green, N, Gregoir, T, Grey, T, Groundwater, E, Grove, T, Growcott, S, Gunasekaran, S, Habib, H, Haddow, J, Halahakoon, V, Halkias, C, Hall, C, Hampson, A, Hancock, L, Hanna, T, Hannay, J, Harikrishnan, A, Harries, R, Harris, G, Hartley, J, Harvey, K, Hawkin, P, Hawkins, J, Healy, R, Heard, R, Heartshorne, R, Heller, S, Hendra, L, Herrod, P, Heywood, N, Hicks, G, Hobson, B, Holtham, S, Hope, C, Hopley, P, Hossain, T, Hossaini, S, Howse, F, Hubbard, T, Humphreys, A, Ikram, H, Ioannis, M, Iqbal, M, Iqbal, N, Jain, R, Jatania, J, Jenkinson, P, Jokhan, S, Jones, A, Jones, C, Jones, L, Joshi, H, Joshi, K, Joy, M, Jull, P, Kakaniaris, G, Kallam, R, Kane, E, Kang, P, Kanitkar, R, Kauser, S, Kazmi, F, Kedrzycki, M, Kelly, S, Kendall, J, Khan, M, Khan, T, King, G, Kisiel, A, Kitsis, C, Kolawole, I, Korambayil, S, Kosasih, S, Kosti, A, Kotb, A, Kouris, S, Kshatriya, K, Kumar, S, Lafaurie, G, Lal, R, Lau, A, Lazim, T, Lazzaro, A, Lee, K, Lefroy, R, Leinhardt, D, Lennon, H, Leong, K, Levy, B, Lim, E, Lim, J, Lindley, S, Liu, D, Lloyd, P, Locker, D, Lockwood, S, Lowe, C, Lund, J, Lunevicius, R, Lunt, A, Lutfi, S, Luther, A, Luwemba, S, Mahankali‐Rao, P, Mahroof, S, Mai, D, Majid, S, Malik, A, Malik, K, Mann, K, Mansour, S, Manu, N, Mapara, R, Martin, C, Martin, J, Martin, R, Mason, C, Massey, L, Mathias, J, Mathur, P, Maude, K, McArthur, D, McCain, S, McCluney, S, McFall, M, McIlroy, B, McKay, S, McKinley, N, McNair, A, McWhirter, D, Mekhail, P, Mellor, K, Merchant, J, Merker, L, Messenger, D, Miles, A, Mir, S, Mishra, A, Mistry, P, Miu, V, Moat, M, Mockford, K, Mohamed, E, Mohamed, I, Mondragon‐Pritchard, M, Moore, N, Moretti, L, Morris, H, Morrison, T, Morrison‐Jones, V, Moss, J, Moug, S, Mountford, D, Moynihan, R, Muhammad, K, Muldoon‐Smith, D, Mulholland, J, Mullan, M, Murgitroyd, E, Murugaiyan, K, Myers, A, Mykoniatis, I, Nana, G, Nash, T, Nassar, A, Newton, R, Ng, C, Ng, P, Nguyen, K, Nicholas, F, Noor, M, Nowers, J, Nugent, C, Nunn, A, Nunn, R, Obeid, N, O'Callaghan, J, O'Hara, R, Oke, O, Olivier, J, O'Neill, A, O'Neill, S, Osei‐Bordom, D, Osgood, L, Panagiotopoulos, S, Panchasara, B, Parks, R, Patel, H, Patel, P, Patel, R, Patel, S, Pawelec, K, Payne, C, Pearson, K, Perin, G, Peristerakis, I, Petronio, B, Phelan, L, Phillips, J, Pisaneschi, C, Pitt, J, Plunkett‐Reed, K, Ponchietti, L, Pouzi, A, Pouzi, M, Powell, A, Powell‐Chandler, A, Pranesh, N, Proctor, V, Pywell, S, Qureshi, A, Qureshi, N, Rahman, M, Rai, Z, Ramcharan, S, Rangarajan, K, Rashid, M, Reader, H, Rehman, A, Rehman, S, Rengifo, C, Richards, E, Richardson, N, Robinson, A, Robinson, D, Rossi, B, Rutherford, F, Sadien, I, Saghir, T, Sahnan, K, Salahia, G, Sarveswaran, J, Saunders, M, Scott, B, Scott, K, Seager, A, Seal, S, Sezen, E, Shaban, F, Shah, P, Shahmohammadi, M, Shamsiddinova, A, Shankar, S, Sharpe, A, Shatkar, V, Sheel, A, Shields, T, Shinkwin, M, Shurmer, J, Siddika, A, Siddiqui, S, Simson, R, Sinclair, P, Singh, B, Singh, S, Sivaraj, J, Skaife, P, Skelly, B, Skinner, A, Slim, N, Smart, C, Smart, N, Smith, F, Smith, I, Smith, R, Spence, G, Sreedhar, A, Steinke, J, Stevenson, L, Stewart‐Parker, E, Stott, M, Stubbs, B, Stylianides, N, Subramonia, S, Swinkin, M, Swinscoe, M, Symons, N, Tahir, W, Taj, T, Takacs, K, Tam, J, Tan, K, Tani, S, Tanner, N, Tao, D, Taylor, M, Thava, B, Thippeswamy, K, Thomas, C, Thompson, E, Thompson, R, Thompson‐Reil, C, Thorn, C, Tongo, F, Toth, G, Turnbull, A, Turnbull, J, Valero, C, Boxel, G, Varcada, M, Venn, M, Ventham, N, Venza, M, Vimalachandran, D, Virlos, I, Wade, T, Wafi, A, Waite, K, Walker, M, Walker, N, Walker, T, Walsh, U, Wardle, S, Warner, R, Watfah, J, Watson, N, Watt, J, Watts, J, Wayman, J, Weegenaar, C, West, H, West, M, Whitehurst, L, Whyler, M, Wiggans, M, Wijeyekoon, S, Williams, G, Williams, R, Williamson, A, Williamson, J, Wilson, J, Winter, A, Wolpert, L, Wong, J, Yeap, E, Yeong, T, Zaman, S, Zappa, B, and Zosimas, D
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Adult ,Male ,medicine.medical_specialty ,National Audit of Small Bowel Obstruction Steering Group and National Audit of Small Bowel Obstruction Collaborators ,Incisional hernia ,lcsh:Surgery ,030230 surgery ,Abdominal wall ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,NASBO Collaborators ,medicine ,Humans ,Hernia ,Hospital Mortality ,General ,Emergency Treatment ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,Groin ,business.industry ,Mortality rate ,Hazard ratio ,West Midlands Research Collaborative ,General Medicine ,Odds ratio ,Original Articles ,lcsh:RD1-811 ,Middle Aged ,medicine.disease ,Quality Improvement ,United Kingdom ,Surgery ,Hernia, Abdominal ,Bowel obstruction ,medicine.anatomical_structure ,Logistic Models ,030220 oncology & carcinogenesis ,Original Article ,Female ,business ,NASBO Steering Group ,Intestinal Obstruction - 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., This study shows that small bowel obstruction due to abdominal wall hernia is common, typically involves a co‐morbid group of patients and has poor outcomes, including high mortality rates. High mortality from this problem
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- 2020