Cost of bowel obstruction resulting from adhesions

Abstract

Objective: To assess the direct costs associated with bowel obstruction resulting from adhesions.

Design: Prospective study.

Setting: University Hospital, Sweden.

Subjects: 57 patients aged 16 years or older who fulfilled the clinical and radiological criteria of bowel obstruction.

Interventions: None.

Main outcome measures: Course of, and direct costs associated with, the illness.

Results: In 34 of the 57 patients (60%) bowel obstruction was caused by adhesions, and in all 34 the small bowel was obstructed (85% of all cases of small bowel obstruction). 22 of the 42 patients who required a hospital stay of more than 24 hours (52%) had adhesive obstruction, and 10 of these (45%) had to be operated on, 2 of them twice. Major complications occurred in 6 (60%) and one died. In a national perspective, adhesive bowel obstruction may cause 2330 hospital admissions annually, which is associated with an estimated direct cost of about US$13 million.

Conclusions: Adhesions are a serious, common, and costly complication of surgery. Efforts have to be undertaken to control their formation.