Variability in the Management of Adhesive Small Bowel Obstruction in Children
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In brief
In brief
Multi-institutional study of 6,410 pediatric adhesive small bowel obstruction cases reveals significant inter-hospital variability in surgical management, with operative rates ranging from 35% to 75% across 46 institutions. Findings highlight substantial practice variation in clinical decision-making for this common pediatric surgical condition.
Written by the GCMD Library team from the article.
Background
This study assessed inter-hospital variability in operative-vs-nonoperative management of pediatric adhesive small bowel obstruction (ASBO).
Methods
A multi-institutional retrospective study was performed examining patients 1–21 years-of-age presenting with ASBO from 2010–2019 utilizing the Pediatric Health Information System. Multivariable mixed-effects logistic regression was performed assessing inter-hospital variability in operative-vs-nonoperative management of ASBO.
Results
Among 6,410 pediatric ASBO admissions identified at 46 hospitals, 3,239 (50.5%) underwent surgery during that admission. The hospital-specific rate of surgery ranged from 35.3% (95%CI: 28.5%–42.6%) to 74.7% (66.3%–81.6%) in the unadjusted model (p