Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn’s disease
Small bowel obstruction is a known complication of Crohn’s disease. Determining need for operation is a demanding task. The aim of this study was to fine tune the decision-making process by evaluating standard clinical and laboratory parameters in small bowel obstruction of any cause and compare eti...
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| Format: | Article |
| Language: | English |
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MDPI AG
2012-06-01
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| Series: | Gastroenterology Insights |
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| Online Access: | http://www.pagepress.org/journals/index.php/gi/article/view/3293 |
| _version_ | 1811180486144294912 |
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| author | Awad Al Qahtani Christina Holcroft Philip Gordon Andrew Szilagyi |
| author_facet | Awad Al Qahtani Christina Holcroft Philip Gordon Andrew Szilagyi |
| author_sort | Awad Al Qahtani |
| collection | DOAJ |
| description | Small bowel obstruction is a known complication of Crohn’s disease. Determining need for operation is a demanding task. The aim of this study was to fine tune the decision-making process by evaluating standard clinical and laboratory parameters in small bowel obstruction of any cause and compare etiologies. Consecutive patients with Crohn’s disease and small bowel obstruction were selected retrospectively and compared to a randomly selected group of non Crohn’s patients with obstruction over a 9 year period. Twenty-two clinical, laboratory and radiological variables were assessed for the following outcomes: i) diagnosis of Crohn’s; ii) operative or non operative treatment in Crohn’s; iii) operative or non operative treatment without Crohn’s; iv) exacerbation or adhesions causing obstruction among Crohn’s patients. Multivariable models were developed for each outcome using logistic regression. Age less than 50, history of smoking, Jewish ethnicity, white count >11x10E9, neutrophils >7.5x10E9 and platelet volume <9.9 fL, supported the diagnosis of Crohn’s disease. Operation in Crohn’s disease within the same admission was associated with a history of smoking, temperature >38˚, high pulse >100, leukocytosis (>11x10E9) and obstruction on abdominal scan, while operation in patients without Crohn’s in the sentinel admission, was associated with temperature >38˚, tachycardia, leukocytosis (>11x10E9) and previous operation. Confirmation of these predictive patterns in a validation group could help in clinical decisions regarding therapeutic options in an emergency setting. |
| first_indexed | 2024-04-11T09:03:55Z |
| format | Article |
| id | doaj.art-8c592bec645f4fd580561dc043b08fa0 |
| institution | Directory Open Access Journal |
| issn | 2036-7414 2036-7422 |
| language | English |
| last_indexed | 2024-04-11T09:03:55Z |
| publishDate | 2012-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Gastroenterology Insights |
| spelling | doaj.art-8c592bec645f4fd580561dc043b08fa02022-12-22T04:32:42ZengMDPI AGGastroenterology Insights2036-74142036-74222012-06-0141e14e1410.4081/gi.2012.e142167Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn’s diseaseAwad Al Qahtani0Christina Holcroft1Philip Gordon2Andrew Szilagyi3Division of Colorectal Surgery, Jewish General Hospital, McGill University, School of Medicine, MontrealDepartment of Epidemiology, Jewish General Hospital, McGill University, School of Medicine, MontrealDivision of Colorectal Surgery, Jewish General Hospital, McGill University, School of Medicine, MontrealDivision of Gastroenterology, Jewish General Hospital, McGill University, School of Medicine, MontrealSmall bowel obstruction is a known complication of Crohn’s disease. Determining need for operation is a demanding task. The aim of this study was to fine tune the decision-making process by evaluating standard clinical and laboratory parameters in small bowel obstruction of any cause and compare etiologies. Consecutive patients with Crohn’s disease and small bowel obstruction were selected retrospectively and compared to a randomly selected group of non Crohn’s patients with obstruction over a 9 year period. Twenty-two clinical, laboratory and radiological variables were assessed for the following outcomes: i) diagnosis of Crohn’s; ii) operative or non operative treatment in Crohn’s; iii) operative or non operative treatment without Crohn’s; iv) exacerbation or adhesions causing obstruction among Crohn’s patients. Multivariable models were developed for each outcome using logistic regression. Age less than 50, history of smoking, Jewish ethnicity, white count >11x10E9, neutrophils >7.5x10E9 and platelet volume <9.9 fL, supported the diagnosis of Crohn’s disease. Operation in Crohn’s disease within the same admission was associated with a history of smoking, temperature >38˚, high pulse >100, leukocytosis (>11x10E9) and obstruction on abdominal scan, while operation in patients without Crohn’s in the sentinel admission, was associated with temperature >38˚, tachycardia, leukocytosis (>11x10E9) and previous operation. Confirmation of these predictive patterns in a validation group could help in clinical decisions regarding therapeutic options in an emergency setting.http://www.pagepress.org/journals/index.php/gi/article/view/3293clinical predictors, small bowel obstruction |
| spellingShingle | Awad Al Qahtani Christina Holcroft Philip Gordon Andrew Szilagyi Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn’s disease Gastroenterology Insights clinical predictors, small bowel obstruction |
| title | Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn’s disease |
| title_full | Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn’s disease |
| title_fullStr | Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn’s disease |
| title_full_unstemmed | Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn’s disease |
| title_short | Clinical variables related to small bowel obstruction: comparison of patients with and without Crohn’s disease |
| title_sort | clinical variables related to small bowel obstruction comparison of patients with and without crohn s disease |
| topic | clinical predictors, small bowel obstruction |
| url | http://www.pagepress.org/journals/index.php/gi/article/view/3293 |
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