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Evaluation of clinical profiles, surgical experience and outcomes of ileosigmoid knotting in low-resource setup: A retrospective cohort study at Jimma University Medical Center.
- Source :
-
World journal of surgery [World J Surg] 2024 Jun; Vol. 48 (6), pp. 1331-1347. Date of Electronic Publication: 2024 Mar 25. - Publication Year :
- 2024
-
Abstract
- Background: Bowel obstruction is a mechanical or functional blockade of intestinal contents from evacuation to the adjacent distal bowel or external environment. It poses significant morbidity and mortality in both high-income and low-to-middle-income countries. Ileosigmoid knotting is a special form of obstruction where the small bowel often ileum wraps around the sigmoid colon or vice versa. It is the severest form of bowel obstruction, involving both the small and large bowels in a compound manner. It is common where sigmoid volvulus is common and geographic areas with a bulky diet.<br />Methods: An institution-based retrospective cohort study was employed among purposively selected 40 surgical patients with ileosigmoid knotting records from July 2020 to July 2023 at Jimma University Medical Center. To estimate and compare the survival probabilities, the Kaplan-Meir method and log-rank test were used. A Cox-regression analysis was fitted to identify independent predictors of time to death.<br />Results: Among a cohort of 40 patients followed for 347 person-days at Jimma University Medical Center, 11 (27.5%) had died. The overall incidence rate of death was 3.2 (95% CI 1.8, 5.7) per 100 person-days. In multivariable Cox-regression analysis, age (AHR = 1.15; 95% CI: 1.04-1.28), shock at presentation (AHR = 30.50: 95% CI 1.25-742.54), comorbidities (AHR = 5.81; 95% CI 1.19-28.23), pulse rate intraoperatively (AHR = 1.19; 95% CI: 1.01-1.40), postoperative pulse rate (AHR = 1.07; 95% CI: 1.01-1.14) were independently associated with time to death.<br />Conclusion: The incidence of death among surgical patients with ileosigmoid knotting was high and also had a shorter median survival time. Age, shock at presentation, comorbidities, pulse rate intraoperatively, and postoperative pulse rate were found to be statistically significant predictors of time to death and outcome among surgical patients with Ileosigmoid knotting.<br /> (© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)
- Subjects :
- Humans
Retrospective Studies
Male
Female
Adult
Middle Aged
Intestinal Obstruction surgery
Intestinal Obstruction etiology
Intestinal Obstruction mortality
Sigmoid Diseases surgery
Sigmoid Diseases mortality
Ileal Diseases surgery
Ileal Diseases mortality
Academic Medical Centers
Aged
Developing Countries
Treatment Outcome
Cohort Studies
Young Adult
Intestinal Volvulus surgery
Intestinal Volvulus mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2323
- Volume :
- 48
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- World journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 38526512
- Full Text :
- https://doi.org/10.1002/wjs.12155