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BMC Surgery
Published in: BMC Surgery 1/2023

Open Access 01-12-2023 | Constipation | Research

Magnitude and predictors of unfavorable management outcome in surgically treated patients with intestinal obstruction in Ethiopia: a systematic review and meta-analysis

Authors: Fentahun Adane, Megbar Dessalegn

Published in: BMC Surgery | Issue 1/2023

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Abstract

Background

Unless an emergency surgical intervention is conducted, intestinal obstruction may result in high morbidity and mortality. In Ethiopia, the magnitude and predictors of unfavorable management outcomes in surgically treated patients with intestinal obstruction are highly variable and inconsistent. The aim of this study was; therefore, to estimate the overall prevalence of unfavorable management outcome and its predictors among surgically treated patients with intestinal obstruction in Ethiopia.

Method

We searched articles from databases from June 1, 2022, to August 30, 2022. Cochrane Q test statistics and I2 tests were applied. We used a random-effect meta-analysis model to overcome the impact of heterogeneity among the included studies. In addition, the association between risk factors and unfavorable management outcome in surgically treated patients with intestinal obstruction was investigated.

Results

This study included a total of twelve articles. The pooled prevalence of unfavorable management outcome in surgically treated patients with intestinal obstruction was 20.22% (95% CI: 17.48–22.96). According to a sub-group analysis by region, Tigray region had the highest prevalence of poor management outcome, which was 25.78% (95% CI: 15.69–35.87). Surgical site infection was the most commonly reported symptom of poor management outcome (8.63%; 95% CI: 5.62, 11.64). The length of postoperative hospital stays (95% CI: 3.02, 29.08), duration of illness (95% CI: 2.44, 6.12), presence of comorbidity (95% CI: 2.38, 10.11), dehydration (95% CI: 2.07, 17.40), and type of intraoperative procedure (95% CI: 2.12, 6.97) were all significantly associated with unfavorable management outcome of intestinal obstruction among surgically treated patients in Ethiopia.

Conclusion

According to this study, the magnitude of unfavorable management outcome was high among surgically treated patients in Ethiopia. Unfavorable management outcome was significantly associated with the length of postoperative hospital stays, duration of illness, comorbidity, dehydration, and type of intraoperative procedure. Medical, surgical and public health measures are pivotal to reduce unfavorable management outcome in surgically treated intestinal obstruction patients in Ethiopia.
Appendix
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Literature
1.
Ullah S, Khan M: Intestinal obstruction: a spectrum of causes, Department of surgery, postgraduate medical institute Lady Reading hospital, Peshawar Pakistan. JPMI 2008, 8(1):210–213.
2.
Dítě P, Lata J, Novotný I: Intestinal obstruction and perforation–the role of the gastroenterologist. Digestive Diseases 2003, 21(1):63–67.PubMedCrossRef
3.
Miller G, Boman J, Shrier I, Gordon PH: Etiology of small bowel obstruction. The American Journal of Surgery 2000, 180(1):33–36.PubMedCrossRef
4.
Miller G, Boman J, Shrier I, Gordon P: Natural history of patients with adhesive small bowel obstruction. British journal of surgery 2000, 87(9):1240–1247.PubMedCrossRef
5.
Ayalew T: Small intestinal volvulus in adults of Gonder region, northwestern Ethiopia. Ethiopian Medical Journal 1992, 30(2):111–117.
6.
Demissie M: Small intestinal volvulus in Southern Ethiopia. East African medical journal 2001, 78(4):208–211.PubMedCrossRef
7.
CM T: Sabiston textbook of surgery. Surgical infections and choice of antibiotics 2004, 1:257–283.
8.
Okello TR, Ogwang DM, Kisa P, Komagum P: Sigmoid volvulus and ileosigmoid knotting at St. Mary’s Hospital Lacor in Gulu, Uganda. East and central African journal of surgery 2009, 14(2):58–64.
9.
Tsegaye S, Osman M, Bekele A: Surgically treated Acute Abdomen at Gondar University Hospital, Ethiopia. East and Central African Journal of Surgery 2007, 12(1):53–57.
10.
Gebre S: Causes and outcome of surgically treated non-traumatic surgical acute abdomen in Suhul general hospital, Shire, northwest Tigray, Ethiopia, a retrospective study. American Academic Scientific Research Journal for Engineering, Technology, and Sciences 2016, 16(1):74–89.
11.
Mustefa M, Lemessa O: Prevalence and factors associated with surgical acute abdomen at Gelemso general hospital, Oromia regional state, eastern Ethiopia. Harmaya University; 2016.
12.
Mariam TG, Abate AT, Getnet MA: Surgical management outcome of intestinal obstruction and its associated factors at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2018. Surgery research and practice 2019, 2019.
13.
Sridhar M, Susmitha C: Incidence and causes of relaparotomy after an obstetric and gynaecological operation. International Surgery Journal 2016, 3(1):301–304.CrossRef
14.
Tiwari SJ, Mulmule R, Bijwe VN: A clinical study of acute intestinal obstruction in adults-based on etiology, severity indicators and surgical outcome. Int J Res Med Sci 2017, 5(8):3688–3696.CrossRef
15.
Otu A: Tropical surgical abdominal emergencies: acute appendicitis. Tropical and geographical medicine 1989, 41(2):118–122.PubMed
16.
Ogbonna B, Obekpa P, Momoh J, Ige J, Ihezue C: Another look at acute appendicitis in tropical Africa: and the value of laparoscopy in diagnosis. Tropical doctor 1993, 23(2):82–84.PubMedCrossRef
17.
Ntakiyiruta G, Mukarugwiro B: The pattern of intestinal obstruction at Kibogola Hospital, a Rural Hospital in Rwanda. East and central African journal of surgery 2009, 14(2):103–108.
18.
Palter VN, Orzech N, Reznick RK, Grantcharov TP: Validation of a structured training and assessment curriculum for technical skill acquisition in minimally invasive surgery: a randomized controlled trial. In.: LWW; 2013.
19.
Wossen MT: Pattern of emergency surgical operations performed for non-traumatic acute abdomen at Ayder Referral Hospital, Mekelle University, Tigrai, Ethiopia by the Year 2000–2003 Ec. Journal of Clinical Trials 2019, 9(5):1–4.
20.
Malik AM, Shah M, Pathan R, Sufi K: Pattern of acute intestinal obstruction: is there a change in the underlying etiology? Saudi journal of gastroenterology: official journal of the Saudi Gastroenterology Association 2010, 16(4):272.PubMedCrossRef
21.
Gupta H, Anand S: A study of forty eight patients with ilecoceacal mass presenting as intestinal obstruction requires surgical intervention and their outcome. International Surgery Journal 2020, 7(8):2563–2567.CrossRef
22.
Zbar RI: The postoperative incidence of small bowel obstruction following various abdominal procedures: a six year retrospective cohort study at Yale-New Haven Hospital. 1992.
23.
Jemere T, Getahun B, Tesfaye M, Muleta G, Yimer N: Causes and Management Outcome of Small Intestinal Obstruction in Nekemte Referral Hospital, Nekemte, Ethiopia, 2017. Surgery Research and Practice 2021, 2021.
24.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS medicine 2009, 6(7):e1000100.PubMedPubMedCentralCrossRef
25.
Rethlefsen ML, Page MJ: PRISMA 2020 and PRISMA-S: common questions on tracking records and the flow diagram. Journal of the Medical Library Association: JMLA 2022, 110(2):253.PubMedPubMedCentral
26.
Rethlefsen ML, Kirtley S, Waffenschmidt S, Ayala AP, Moher D, Page MJ, Koffel JB: PRISMA-S: an extension to the PRISMA statement for reporting literature searches in systematic reviews. Systematic reviews 2021, 10(1):1–19.CrossRef
27.
28.
Rücker G, Schwarzer G, Carpenter JR, Schumacher M: Undue reliance on I 2 in assessing heterogeneity may mislead. BMC medical research methodology 2008, 8(1):79.PubMedPubMedCentralCrossRef
29.
Sterne JA, Egger M: Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. Journal of clinical epidemiology 2001, 54(10):1046–1055.PubMedCrossRef
30.
Deutchman M, Connor P, Gobbo R, FitzSimmons R: Outcomes of cesarean sections performed by family physicians and the training they received: a 15-year retrospective study. The Journal of the American Board of Family Practice 1995, 8(2):81–90.PubMed
31.
Aubrey-Bassler K, Newbery S, Kelly L, Weaver B, Wilson S: Maternal outcomes of cesarean sections: do generalists’ patients have different outcomes than specialists’ patients? Canadian Family Physician 2007, 53(12):2132–2138.PubMedPubMedCentral
32.
Minneci PC, Mahida JB, Lodwick DL, Sulkowski JP, Nacion KM, Cooper JN, Ambeba EJ, Moss RL, Deans KJ: Effectiveness of patient choice in nonoperative vs surgical management of pediatric uncomplicated acute appendicitis. JAMA surgery 2016, 151(5):408–415.PubMedCrossRef
33.
Abbasi N, Patenaude V, Abenhaim H: Management and outcomes of acute appendicitis in pregnancy—population-based study of over 7000 cases. BJOG: An International Journal of Obstetrics & Gynaecology 2014, 121(12):1509–1514.CrossRef
34.
Dandena F, Leulseged B, Suga Y, Teklewold B: Magnitude and pattern of inpatient surgical mortality in a tertiary hospital in Addis Ababa, Ethiopia. Ethiopian Journal of Health Sciences 2020, 30(3).
35.
Melkie A, Alemayehu T, Tarekegn E: Pattern of acute abdomen in Dil Chora referral hospital, Eastern Ethiopia. International Journal of Collaborative Research on Internal Medicine & Public Health 2016, 8(11):0–0.
36.
Gebresellassie HW, Tamerat G: Audit of surgical services in a teaching hospital in Addis Ababa, Ethiopia. BMC research notes 2019, 12(1):1–5.CrossRef
37.
Kotiso B, Abdurahman Z: Pattern of Acute Abdomen in Adult Patients in Tikur Anbessa Teaching Hospital, Addis Ababa, Ethiopia. East and central African journal of surgery 2007, 12(1):47–52.
38.
Ayenew Z, Gizaw A, Workneh D, Fentahun N: Outcome of non-traumatic surgical acute abdomen in nekemte referral hospital southwest Ethiopia: a retrospective cross-sectional study. Surgery Curr Res 2016, 7(282):1–5.
39.
Tassew B, Haile M, Tefera T, Balda S, Gonfa K, Mubashir K: Presentation and outcome of acute abdomen in Goba Referral Hospital, Goba, Southeast Ethiopia: retrospective study. SM Journal of Family Medicine 2017, 1:1–4.
40.
Ademe S, Edmealem A, Tegegne B, Mengesha Z: Management outcome of intestinal obstruction done by integrated emergency surgical officers and its associated factors in selected district hospitals of South Wollo Zone, North East Ethiopia in 2019 GC. Annals of Clinical Gastroenterology and Hepatology 2021, 5(1):025–031.CrossRef
41.
Fentahun A, Amsalu B, Belay W, Yalewu D: Magnitude and management outcome predictors of mechanical large bowel obstruction. Ethiopian Medical Journal 2021, 59(02).
42.
Derseh T, Dingeta T, Yusouf M, Minuye B: Clinical outcome and predictors of intestinal obstruction surgery in Ethiopia: a cross-sectional study. BioMed Research International 2020, 2020.
43.
Soressa U, Mamo A, Hiko D, Fentahun N: Prevalence, causes and management outcome of intestinal obstruction in Adama Hospital, Ethiopia. BMC surgery 2016, 16(1):1–8.CrossRef
44.
Atalay M, Gebremickael A, Demissie S, Derso Y: Magnitude, pattern and management outcome of intestinal obstruction among non-traumatic acute abdomen surgical admissions in Arba Minch General Hospital, Southern Ethiopia. BMC surgery 2021, 21(1):1–8.CrossRef
45.
Batebo M, Loriso B, Beyene T, Haile Y, Hailegebreal S: Magnitude and determinants of treatment outcome among surgically treated patients with intestinal obstruction at Public Hospitals of Wolayita Zone, Southern Ethiopia: a cross sectional study, 2021. BMC surgery 2022, 22(1):1–8.CrossRef
46.
Gebrie T, Handiso T, Hagisso S: Management outcome and associated factors of surgically treated non traumatic acute abdomen at Attat Hospital, Zone, Ethiopia. Int J Surg Res Pract 2019, 6:099.
47.
Girma H, Negesso M, Tadese J, Hussen R, Aweke Z: Management outcome and its associated factors among surgically treated intestinal obstruction cases in Dilla University Referral Hospital, Southern Ethiopia. A cross-sectional study. International Journal of Surgery Open 2021, 33:100351.CrossRef
48.
Hagos M: ACUTE ABDOMEN IN ADULTS: A TWO YEAR EXPERIENCE IN MEKELLE, ETHIOPIA. Ethiopian medical journal 2015, 53(1):19–24.PubMed
49.
Bankole AO, Osinowo AO, Adesanya AA: Predictive factors of management outcome in adult patients with mechanical intestinal obstruction. Nigerian Postgraduate Medical Journal 2017, 24(4):217.PubMedCrossRef
50.
Souvik A, Hossein MZ, Amitabha D, Nilanjan M, Udipta R: Etiology and outcome of acute intestinal obstruction: a review of 367 patients in Eastern India. Saudi journal of gastroenterology: official journal of the Saudi Gastroenterology Association 2010, 16(4):285.CrossRef
51.
Springer JE, Bailey JG, Davis PJ, Johnson PM: Management and outcomes of small bowel obstruction in older adult patients: a prospective cohort study. Canadian Journal of Surgery 2014, 57(6):379.PubMedCentralCrossRef
52.
Otieno GN: Adhesive Post Operative small bowel obstruction In Adult patients as seen at the Kenyatta National Hospital. University of Nairobi; 2016.
53.
Birhanu Y, Endalamaw A: Surgical site infection and pathogens in Ethiopia: a systematic review and meta-analysis. Patient safety in surgery 2020, 14(1):1–8.
54.
Ooko PB, Sirera B, Saruni S, Topazian HM, White R: Pattern of adult intestinal obstruction at Tenwek hospital, in south-western Kenya. Pan African Medical Journal 2015, 20(1).
55.
Mwita JC, Souda S, Magafu MG, Massele A, Godman B, Mwandri M: Prophylactic antibiotics to prevent surgical site infections in Botswana: findings and implications. Hospital practice 2018, 46(3):97–102.PubMedCrossRef
56.
Berenguer CM, Ochsner Jr MG, Lord SA, Senkowski CK: Improving surgical site infections: using National Surgical Quality Improvement Program data to institute Surgical Care Improvement Project protocols in improving surgical outcomes. Journal of the American College of Surgeons 2010, 210(5):737–741.PubMedCrossRef
57.
Daskalakis K, Juhlin C, Påhlman L: The use of pre-or postoperative antibiotics in surgery for appendicitis: a systematic review. Scandinavian Journal of Surgery 2014, 103(1):14–20.PubMedCrossRef
58.
Coakley BA, Sussman ES, Wolfson TS, Bhagavath AS, Choi JJ, Ranasinghe NE, Lynn ET, Divino CM: Postoperative antibiotics correlate with worse outcomes after appendectomy for nonperforated appendicitis. Journal of the American College of Surgeons 2011, 213(6):778–783.PubMedCrossRef
59.
Hawn MT, Richman JS, Vick CC, Deierhoi RJ, Graham LA, Henderson WG, Itani KM: Timing of surgical antibiotic prophylaxis and the risk of surgical site infection. JAMA surgery 2013, 148(7):649–657.PubMedCrossRef
60.
Allegranzi B, Bischoff P, de Jonge S, Kubilay NZ, Zayed B, Gomes SM, Abbas M, Atema JJ, Gans S, van Rijen M: New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. The Lancet Infectious Diseases 2016, 16(12):e276-e287.PubMed
61.
Okeny P, Hwang T, Ogwang D: Acute bowel obstruction in a Rural Hospital in Northern in Northern Uganda. East and Central African Journal of Surgery 2011, 16(1).
62.
Curtis L: Prevention of hospital-acquired infections: review of non-pharmacological interventions. Journal of Hospital Infection 2008, 69(3):204–219.PubMedCrossRef
63.
Kapan M, Onder A, Polat S, Aliosmanoglu I, Arikanoglu Z, Taskesen F, Girgin S: Mechanical bowel obstruction and related risk factors on morbidity and mortality. Journal of Current surgery 2012, 2(2):55–61.
64.
Rosenberg CS: Wound healing in the patient with diabetes mellitus. Nursing Clinics of North America 1990, 25(1):247–261.PubMedCrossRef
65.
Chan HY, Cheng A, Cheung SS, Pang Ww, Ma Wy, Mok Lc, Wong Wk, Lee DT: Association between dehydration on admission and postoperative complications in older persons undergoing orthopaedic surgery. Journal of Clinical Nursing 2018, 27(19–20):3679–3686.PubMedCrossRef
Metadata
Title
Magnitude and predictors of unfavorable management outcome in surgically treated patients with intestinal obstruction in Ethiopia: a systematic review and meta-analysis
Authors
Fentahun Adane
Megbar Dessalegn
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2023
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-023-02017-3

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