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. 2012 Sep;204(3):315-20.
doi: 10.1016/j.amjsurg.2011.10.023. Epub 2012 May 9.

Secular trends in small-bowel obstruction and adhesiolysis in the United States: 1988-2007

Frank I Scott  1 , Mark T Osterman, Najjia N Mahmoud, James D Lewis
Affiliations

Secular trends in small-bowel obstruction and adhesiolysis in the United States: 1988-2007

Frank I Scott et al. Am J Surg. 2012 Sep.

Abstract

Background: Postoperative adhesions are common after surgery and can cause small-bowel obstruction (SBO) and require adhesiolysis. The impact that laparoscopy and other surgical advances have had on rates of SBO and adhesiolysis remains controversial. This study examines trends in discharges from US hospitals for SBO and adhesiolysis from 1988 to 2007.

Methods: We performed an analysis of secular trends for SBO and adhesiolysis, using the National Hospital Discharge Survey. Spearman correlation coefficients were calculated to assess trends over time.

Results: Rates of SBO were stable over time (ρ = .140; P = .28). Adhesiolysis rates were stable over time (ρ = -.18; P = .17), although there were significant downward trends in patients older than age 65 (ρ = -.55; P = .01) and age 15 to 44 (ρ = -.84; P < .01).

Conclusions: There has been no significant change in overall rates of SBO or adhesiolysis from 1988 to 2007. For adhesiolysis, there were decreasing trends when stratified by age. Further research is required to understand the factors associated with adhesion-related complications.

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Figures

Figure 1
Figure 1
Rates of hospitalization for SBO per 100,000 persons from 1988 to 2007. Diamonds (♦) represent discharges for those 15–44 years old, triangles (▲) represent those 45 to 64 years of age, and circles (●) represent those 65 or older. There was no significant trend overall (ρ=0.14, p=0.28). Those 15–44 years old did have a significant upward trend (ρ=0.70, p<0.01), though events were low in this age group.
Figure 2
Figure 2
Rates of hospitalization for adhesiolysis per 100,000 persons from 1988 to 2007. Circles (●) represent those 15–44 years old, diamonds (♦) represent those 45 to 64, and triangles (▲) represent those 65 and older. While there was no significant trend overall for adhesiolysis (ρ=−0.17, p=0.19), there were statistically significant decreasing rates over time in those 15 to 44 (ρ=−0.84, p<0.01), and those 65 and older (ρ=−0.55, p=0.01).
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