Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2017 Oct 5;7(10):e016796.
doi: 10.1136/bmjopen-2017-016796.

UK-based, multisite, prospective cohort study of small bowel obstruction in acute surgical services: National Audit of Small Bowel Obstruction (NASBO) protocol

Matthew J Lee  1   2 , Adele E Sayers  2   3 , Thomas M Drake  2   4 , Marianne Hollyman  5   6 , Mike Bradburn  7 , Daniel Hind  7 , Timothy R Wilson  8   9 , Nicola S Fearnhead  9   10 ; NASBO Steering Group
Affiliations
Multicenter Study

UK-based, multisite, prospective cohort study of small bowel obstruction in acute surgical services: National Audit of Small Bowel Obstruction (NASBO) protocol

Matthew J Lee et al. BMJ Open. .

Abstract

Introduction: Small bowel obstruction (SBO) is a common indication for emergency laparotomy in the UK, which is associated with a 90-day mortality rate of 13%. There are currently no UK clinical guidelines for the management of this condition. The aim of this multicentre prospective cohort study is to describe the burden, variation in management and associated outcomes of SBO in the UK adult population.

Methods and analysis: UK hospitals providing emergency general surgery are eligible to participate. This study has three components: (1) a clinical preference questionnaire to be completed by consultants providing emergency general surgical care to assesses preferences in diagnostics and therapeutic approaches, including laparoscopy and nutritional interventions; (2) site resource profile questionnaire to indicate ease of access to diagnostic services, operating theatres, nutritional support teams and postoperative support including intensive care; (3) prospective cohort study of all cases of SBO admitted during an 8-week period at participating trusts. Data on diagnostics, operative and nutritional interventions, and in-hospital mortality and morbidity will be captured, followed by data validation.

Ethics and dissemination: This will be conducted as a national audit of practice in conjunction with trainee research collaboratives, with support from patient representatives, surgeons, anaesthetists, gastroenterologists and a clinical trials unit. Site-specific reports will be provided to each participant site as well as an overall report to be disseminated through specialist societies. Results will be published in a formal project report endorsed by stakeholders, and in peer-reviewed scientific reports. Key findings will be debated at a focused national meeting with a view to quality improvement initiatives.

Keywords: Small bowel obstruction; nutrition; surgery.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Conceptual schematic of pathways in the management of small bowel obstruction, including typical diagnoses and nutritional outcomes. TPN, total parenteral nutrition.
Figure 2
Figure 2
Components of NASBO (National Audit of Small Bowel Obstruction) study, and how they are related. BMI, body mass index.
See this image and copyright information in PMC

References

    1. National Emergency Laparotomy Audit. The second patient report of the national emergency laparotomy audit (NELA) December 2014 to November 2015. London, 2016.
    1. Scott JW, Olufajo OA, Brat GA, et al. . Use of national burden to define operative emergency general surgery. JAMA Surg 2016;151:e160480 10.1001/jamasurg.2016.0480 - DOI - PubMed
    1. Maung AA, Johnson DC, Piper GL, et al. . Evaluation and management of small-bowel obstruction. J Trauma Acute Care Surg 2012;73:S362–S369. 10.1097/TA.0b013e31827019de - DOI - PubMed
    1. Di Saverio S, Coccolini F, Galati M, et al. . Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2013 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg 2013;8:42 10.1186/1749-7922-8-42 - DOI - PMC - PubMed
    1. Fevang BT, Jensen D, Svanes K, et al. . Early operation or conservative management of patients with small bowel obstruction? Eur J Surg 2002;168:475–81. 10.1080/110241502321116488 - DOI - PubMed

Publication types