Adhesion intestinal obstruction in children in northern Nigeria

Study on clinical characteristics and related factors of schizophrenic patients with intestinal obstruction

BACKGROUND

There are still few studies on the clinical characteristics and related risk factors of schizophrenia patients with intestinal obstruction. Our aim is to explore the clinical characteristics and related risk factors of schizophrenia patients with intestinal obstruction.

METHODS

This study focused on schizophrenia patients with intestinal obstruction who were hospitalized in the psychiatric department of a hospital in Wuhan from January 2007 to December 2020 as the main research object. We intend to retrospectively analyze the clinical characteristics and related risk factors of schizophrenia patients with intestinal obstruction.

RESULTS

In the 1937 persons with schizophrenia included in this study, 97 patients were complicated with intestinal obstruction, and the incidence was 5.01%.The results of the study showed that patients with age ≥ 60 years old, visiting time ≥ 24 h, hospital stay ≥ 90 days, history of abdominal surgery, course of disease ≥ 5 years, male, and patients with cardiovascular and cerebrovascular diseases are prone to intestinal obstruction; Logistic multiple regression analysis showed that the related risk factors of schizophrenia patients with intestinal obstruction mainly included the patient's age, visiting time, length of hospital stay, history of abdominal surgery, course of disease and gender.

CONCLUSION

The older the age, the longer the hospital stay, the longer the course of the disease, the history of previous surgery, and the male schizophrenia who do not see a doctor within 24 h of the onset, the risk of intestinal obstruction is higher, and it is easy to be misdiagnosed and even life-threatening.

Cost effectiveness analysis of duration of nonoperative management for adhesive bowel obstruction in a developing country

Background

Adhesive bowel obstruction (ABO) costs billions of dollars in developed countries. Cost is unknown in developing countries. This depends on the type of management and duration of hospital stay. Nonoperative management (NOM) of uncomplicated obstruction is safe for up to 10 days. While it remains cost effective, the most efficient duration of nonoperative management must retain its advantages over operative management.

Aim

To describe cost effectiveness of various durations of nonoperative management of adhesive obstruction in a developing country.

Method

Over 2 year period, Patients who had uncomplicated adhesive obstruction were observed on trial of nonoperative management. Length of hospital stay and success rate were combined as surrogates for Cost effectiveness analysis of 2 to 5 days and ≥7 days nonoperative management.

Results

41 patients (24(58.5%) females) were eligible. Mean age 38.4 ± 14.7 (range 18–80) years. 31 (75.6%) were first time admissions. The most common previous abdominal operations were for appendix and obstetrics and gynecologic pathologies. Median duration of nonoperative management (dNOM) was 4 days, median LOS was 9 days. Nonoperative management was successful in 53.7% (22 patients). Total estimated direct hospital cost of 41 adhesive bowel obstructions was $133,279. Total personnel charges were $112,142. Mean operative and nonoperative management was $4,914 and $1,814 respectively (p <0.0001). Most of successful nonoperative management was within 5 days. 4 days nonoperative management had the highest cost utility.

Conclusion

From this study, without indications for immediate surgical intervention, 4 days nonoperative management is the most cost effective course, after which surgical intervention may be considered if there is no improvement.