Etiology And Clinical Outcomes Of Adult Intestinal Obstruction: Changing With Age?

Objective To discuss different etiology distribution in patients with intestinal obstruction in all age groups and analyze etiology, treatment, clinical outcomes and age of adult intestinal obstruction.Methods We collect 500 cases of intestinal obstruction from January 2008 to December 2013 in the Affiliated Hospital of Qingdao University Medical College in the Past 6 years. Divided the cases into four groups according to age:youth group,middle-aged group, young elderly group and elderly group. Aggregately analyze etiology,treatment, length of stay, incorporative disease and fatality rate of patients in all age groups. Statistical analysis was performed by using SPSS 17.0 statistics software.Result Of the 500 cases, there were 58 cases in youth group, 139 cases in middle-aged group, 170 cases in young elderly group and 133 cases in elderly group. The ratios of each group classified by age was statistically significant different(P<0.01).The most common causes of intestinal obstruction are adhesion, neoplasm and bezoar. Neoplasm is the first causes in old group and adhesion is the first in the other three groups, which had statistical differences(P<0.01).The average length of stay of expectant treatment patients was significantly shorter than that of surgery patients in each groups(P<0.01). Of the patients were treated by conservative treatment, the average length of stay in youth group was shortest of the four groups, and there was no difference between youth group and middle-aged group(P>0.05).Of the patients were treated by surgical treatment, the average lengths of stay were not significantly different between not only youth group and middle-aged group but also young elderly group and elderly group.(p>0.05), while, there were statistical differences in the other different groups(p<0.05).The surgical operation rate was 46.55%in youth group,56.12%in middle-agedgroup,55.29%in young elderly group and 64.66% in elderly group. Above all, there was statistical difference between youth group and elderly group(p<0.05).The incorporative disease rates by turns youth group, middle-aged group, young elderly group and elderly group,and was significantly different in different groups(P<0.01), except that between youth group and middle-aged group, young elderly group and elderly group.(p>0.05).The mortality rates accounted for 0% in youth group, 0.7% in middle-aged group,2.35% in young elderly group and 4.51% in elderly group. It was significantly higher in elderly group than that in middle-aged group(P<0.05). However, there was no statistical differences in the other different groups(p>0.05).Correlation analysis showed that the length of stay, surgical operation rate,incorporative disease rates and mortality rates of patients with intestinal obstruction were positively correlated and increased with patient’s age(P<0.05).Conclusion1. The proportions of patients with intestinal obstruction are different in different groups. The cases of youth group occupy the least proportion.2. Different etiology distributions in patients with intestinal obstruction in different age groups vary widely. The most common causes of intestinal obstruction are adhesion,neoplasm and bezoar.. Neoplasm is the first causes in old group and adhesion is the first in the other three groups3. There are differences in treatment and clinical outcome in different age groups.4. The length of stay, incorporative disease rates and mortality rates of patients with intestinal obstruction were positively correlated with patient’s age.