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Development of a simple model for predicting need for surgery in patients who initially undergo conservative management for adhesive small bowel obstruction.

Abstract：

BACKGROUND:Among patients with adhesive small bowel obstruction (ASBO) initially managed with a conservative strategy, predicting risk of operation is difficult. METHODS:We investigated ASBO patients at 2 different periods to derive and validate a clinical prediction model for risk of operation. RESULTS:One hundred fifty-four patients were enrolled into the derivation cohort and 96 into the validation cohort. Based on the derived scoring, including age > or =65 years, presence of ascites, and gastrointestinal drainage volume >500 mL on day 3, each patient was classified into 1 of 4 risk classes from low risk to high risk. When applied to the validation cohort, the positive predictive value (PPV) for operation in the high-risk class was 72%, while the negative predictive value (NPV) in the low-risk class was 100% with high sensitivity (100%) and specificity (96%). CONCLUSIONS:The prediction model performs well for risk stratification of need for surgical intervention following conservative strategy among ASBO patients.

journal_name

Am J Surg

journal_title

American journal of surgery

authors

Komatsu I,Tokuda Y,Shimada G,Jacobs JL,Onodera H

doi

10.1016/j.amjsurg.2009.07.045

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

215-23

issue

2

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(09)00676-X

journal_volume

200

pub_type

杂志文章

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