Variability in the Management of Adhesive Small Bowel Obstruction in Children

Space: StayCurrentMD Author: Jordan C. Apfeld, Jennifer N. Cooper, Lindsay A. Gil, Afif N. Kulaylat, Nathan S. Rubalcava, Carley M. Lutz, Katherine J. Deans, Peter C. Minneci, K. Elizabeth Speck Published:

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Jordan C. Apfeld, Jennifer N. Cooper, Lindsay A. Gil, Afif N. Kulaylat, Nathan S. Rubalcava, Carley M. Lutz, Katherine J. Deans, Peter C. Minneci, K. Elizabeth Speck

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Abstract

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

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