Comparision of attributes between young and old patients who died in hospital after bowel obstruction: A multicenter retrospective cohort study

Abstract

Background

Intestinal obstruction is one of the most frequent emergencies in gastrointestinal surgery and can concern patients of all ages and be life threatening. Postoperative mortality is reported to be higher in elderly patients, but there is currently no published study encompassing all patients regardless of their treatment. The aim of the present study was to compare outcomes between older and younger patients deceased after all kind bowel obstruction treated surgically or not.

Methods

We retrospectively included all consecutive patients declared dead following bowel obstruction, from 2007 to 2020, in 3 University hospital in Lyon, France. Patients were classified according to age, <75 and ≥75 years based on the definition of elderly patients of the French Haute Autorité de Santé. Patient's selection was made with the hospital discharge database and medical records were collected from the local electronic database.

Results

A total of 222 patients were included; 130 patients were aged ≥75 years and 92 < 75 years. Most patients did not show signs of severity at admission. Patients ≥75 years had a higher rate of death by acute respiratory distress (p = 0.02), while there is a trend to a higher frequency of death by general deterioration in a context of advanced cancer in the younger group (p = 0.06).

Conclusion

Intra-hospital death after bowel obstruction concerns patients of all ages, treated surgically or not. Elderly patients die from respiratory complications, and younger ones die from general deterioration in context of cancer. Most deceased patients did not show signs of severity at admission.