Clinical Outcome and Predictors of Intestinal Obstruction Surgery in Ethiopia: A Cross-Sectional Study

Abstract

Background. Despite the advancement in the healthcare system, the impact of surgical interventions on public health systems will continue to grow. But predicting the outcome is challenging. Concerns related to unexpected outcomes and delays in the diagnosis of postoperative complications are the major issue. Intestinal obstruction is a common life-threatening surgical condition followed by fatal and nonfatal postoperative complications. This study was aimed at assessing results after surgery for intestinal obstruction in a hospital of Ethiopia. Methodology. An institutional-based cross-sectional study was conducted among 254 postoperative patients admitted with intestinal obstruction from January 1, 2014, to December 31, 2017. Data were coded and entered into EpiData 4.2.0.0 software and exported to the Statistical Package for the Social Sciences version 22 for analysis. A binary logistic regression model was used for analysis. All variables with a $p$ value < 0.25 during bivariable analysis were considered for multivariable logistic regression analysis. Results. The magnitude of poor surgical outcome of intestinal obstruction was 21.3% for patients enrolled into this investigation. The age group of ≥55 years ( $\text{adjusted}\text{odds}\text{ratio}\left(\text{AOR}\right)=2.9$ , 95% CI: 1.03, 8.4), duration of illness of ≥24 hrs ( $\text{AOR}=3.1$ , 95% CI: 1.03, 9.4), preoperative diagnosis of a gangrenous large bowel ( $\text{AOR}=3.6$ , 95% CI: 1.3, 9.8), and a gangrenous small bowel ( $\text{AOR}=4.2$ , 95% CI: 1.3, 13.7) were significantly associated with poor surgical outcome. Conclusions. The magnitude of poor surgical outcome was high. Age, late presentation of illness, and gangrenous bowel obstructions were significantly associated with poor outcomes. So, concern should be given in early detection and follow-up of patients who came late and older patients.