Analysis of recurrent ileus admissions to an emergency department

INTRODUCTION: Ileus is a common surgical emergency and tends to recur like other gastrointestinal tract pathologies. Recurrent episodes of ileus cause morbidity and mortality. The aim of this study was to evaluate the clinical characteristics, outcomes, and laboratory parameters of patients who presented with initial and recurrent episodes of ileus.
METHODS: A retrospective observational study at a tertiary care hospital examined adult patients (≥18 years) diagnosed with ileus in the emergency department from January 2018 to March 2021.
RESULTS: This study was performed on 393 ileus patients in the emergency department. Of the patients, 312 (79.4%) were in the initial admission group and 81 (20.6%) were in the recurrent admission group. 144 patients (36.6%) were found to have comorbid diseases and the rate of comorbid patients in the initial group (23.7%, n=74) was significantly lower than in the recurrent group (50.7%, n=41) (p<0.001). Among 337 patients (85.8%) who were followed up on the ward and 56 patients (14.2%) who were followed up in the intensive care unit, the rate of follow-up in the intensive care unit was significantly higher for the initial group (16%, n=50) than for the recurrent group (7.4%, n=6) (p=0.048). In-hospital mortality was 11.5%, and there was no significant difference between the groups (p=0.776). WBC, CRP, CRP/albumin, and RDW/albumin ratios were lower in recurrent admissions, and a statistically significant difference was found between the groups (p=0.034, p<0.001, p=0.001, p=0.013, respectively).
DISCUSSION AND CONCLUSION: In managing patients with recurrent ileus episodes, clinicians may benefit from the findings of this study.

Acil servise baþvuran tekrarlayan ileus vakalarýnýn analizi

GÝRÝÞ ve AMAÇ: Ýleus yaygýn cerrahi acil bir durum olup diðer gastrointestinal sistem patolojileri gibi tekrarlama eðilimine sahiptir ve tekrarlayan ileus ataklarý hastalarda morbidite ve mortaliteye yol açmaktadýr. Bu çalýþmanýn amacý, ilk ve tekrarlayan ileus ataklarý ile baþvuran hastalarýn klinik özelliklerini, sonuçlarýný ve laboratuvar parametrelerini deðerlendirmektir.
YÖNTEM ve GEREÇLER: Üçüncü basamak bir hastanede yapýlan retrospektif gözlemsel bir çalýþmada, Ocak 2018-Mart 2021 tarihleri arasýnda acil serviste ileus tanýsý konan yetiþkin hastalar (≥18 yaþ) incelenmiþtir.
BULGULAR: Bu çalýþma acil servisde ileus tanýsý alan 393 hasta üzerinde gerçekleþmiþtir. Hastalarýn 312 tanesi (79.4%) ilk baþvuru; 81 tanesi (20.6%) tekrarlayan baþvuru grubundaydý. 144 hastanýn (36.6%) komorbid hastalýðý olduðu görüldü ve ilk baþvuru grubunda eþlik eden hasta oraný (23.7%, n=74), tekrarlayan baþvuru grubuna göre (50.7%, n=41) belirgin düþük olarak saptandý (p<0.001). 337 hastanýn (85.8%) serviste, 56 hastanýn (14.2%) yoðun bakýmda takip edildiði çalýþmada; ilk baþvurusu olan hastalarýn yoðun bakýmda takip edilme oraný (16%, n=50), tekrarlayan baþvuruna grubuna göre (7.4%, n=6) belirgin yüksek olarak tespit edildi (p=0.048). Çalýþmada hastane içi mortalite oraný 11.5% olarak tespit edildi ve gruplar arasýnda mortalite oranlarý açýsýndan anlamlý fark görülmedi (p=0.776). Çalýþmamýzda WBC, CRP, CRP/albümin, RDW/albümin oranlarýnýn tekrarlayan baþvuruda daha düþük olduðu saptandý ve gruplar arasýnda istatistiksel olarak anlamlý fark görüldü (sýrasýyla; p=0.034, p<0.001 p<0.001 p=0.013).
TARTIÞMA ve SONUÇ: Bu çalýþmadaki bulgular klinisyenlere tekrarlayan ileus ataklarý olan hastalarýn yönetiminde yardýmcý olabileceðini düþünüyoruz.