Adhesive small bowel obstruction in octogenarians: A 6-year retrospective single-center analysis of clinical management and outcomes

Background: Few evidences are available on adhesive bowel obstruction (ASBO)management and outcomes in\r\ngeriatric patients.\r\nMethods: One-hundred-twenty-eight patients aged 65–79 years were retrospectively compared to 77 patients\r\naged ≥80 years. Aim of this study was to compare ASBO management and in-hospital course between patients\r\naged 65–79 years and those over 80 years.\r\nResults: Upfront surgery in octogenarians related with a higher rate of major complications (23.7%vs4.9%; p =\r\n0.009) and longer hospitalization (8.8vs7.3 days; p = 0.01). No difference according to age was noted in terms of\r\nclinical outcomes when the non-operative management (NOM) was employed. Patients aged ≥80 years managed\r\nconservatively presented shorter hospitalization (7.3vs8.8 days; p = 0.04), lower rate of intensive care unit (ICU)\r\nadmission (0vs18.4%; p = 0.005) and cumulative major complications (2.6%vs23.7%; p = 0.007) as compared to\r\n≥80 years old patients treated with upfront surgery. In this same group, NOM failure did not lead to worse\r\noutcomes in comparison to upfront surgery.\r\nConclusions: NOM in≥80 years patients is associated with better in-hospital course. The acceptable clinical\r\noutcomes in case of NOM failure further support NOM as first treatment strategy to employ in this same subset of\r\npatients.