Who would avoid severe adverse events from nasointestinal tube in small bowel obstruction? A matched case–control study
Abstract Background Nasointestinal tubes (NITs) have been increasingly used in patients with small bowel obstruction (SBO); However, severe adverse events (SAEs) of NITs might threaten the lives of patients. The indications of NITs need to be identified. This study was designed to explore the indica...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-022-02405-8 |
| _version_ | 1818158481486643200 |
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| author | Hui Wang Jun-rong Zhang Shuai Chen Ping Hou Qing-feng Chen Zong-qi Weng Xin-chang Shang-guan Bing-qiang Lin Xian-qiang Chen |
| author_facet | Hui Wang Jun-rong Zhang Shuai Chen Ping Hou Qing-feng Chen Zong-qi Weng Xin-chang Shang-guan Bing-qiang Lin Xian-qiang Chen |
| author_sort | Hui Wang |
| collection | DOAJ |
| description | Abstract Background Nasointestinal tubes (NITs) have been increasingly used in patients with small bowel obstruction (SBO); However, severe adverse events (SAEs) of NITs might threaten the lives of patients. The indications of NITs need to be identified. This study was designed to explore the indications for the insertion of NITs in patients with SBO and to suggest the optimal strategies for individuals based on the outcomes of SAEs. Methods After propensity score matching, 68 pairs were included (Success group and failure group). The occurrence of SAEs and the clinical parameters were compared between the SAE group and the non-SAE group. Independent risk factors were evaluated among the subgroups. A novel scoring system was established to detect the subgroups that would benefit from NITs insertion. Results Successful implementation of NITs could avoid hypochloremia (p = 0.010), SAEs (p = 0.001), pneumonia (p = 0.006). SAEs occurred in 13 of 136 (9.6%) patients who accepted NITs insertion treatment. Risk factors for SAEs included tumors (p = 0.002), reduced BMI (p = 0.048), reduced hemoglobin (p = 0.001), abnormal activated partial thromboplastin time (p = 0.015) and elevated white blood cells (p = 0.002). A novel risk scoring system consists of hemoglobin before NITs insertion (95% CI 0.685, 0.893) and bowel obstruction symptoms relieved after NITs insertion (95% CI 0.575, 0.900) had the highest area under curve for predicting the occurrence of SAEs. We divided the risk score system into 3 grades, with the increasing grades, the rates of SAEs surged from 1.3% (1/74) to (6/11) 54.5%. Conclusion NITs successfully insertion could avoid SAEs occurrence in SBO conservative treatment. SBO patients without anemia and could be relieved after NITs insertion could be the potential benefit group for this therapy. |
| first_indexed | 2024-12-11T15:30:46Z |
| format | Article |
| id | doaj.art-fd9fe60bdf1c47e3a0c76f5bfdf7194c |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-11T15:30:46Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-fd9fe60bdf1c47e3a0c76f5bfdf7194c2022-12-22T01:00:05ZengBMCBMC Gastroenterology1471-230X2022-07-0122111110.1186/s12876-022-02405-8Who would avoid severe adverse events from nasointestinal tube in small bowel obstruction? A matched case–control studyHui Wang0Jun-rong Zhang1Shuai Chen2Ping Hou3Qing-feng Chen4Zong-qi Weng5Xin-chang Shang-guan6Bing-qiang Lin7Xian-qiang Chen8Department of General Surgery (Emergency Surgery), Fujian Medical University Union HospitalDepartment of General Surgery (Emergency Surgery), Fujian Medical University Union HospitalDepartment of General Surgery (Emergency Surgery), Fujian Medical University Union HospitalImmunotherapy Institute, Fujian Medical UniversityDepartment of General Surgery (Emergency Surgery), Fujian Medical University Union HospitalDepartment of General Surgery (Emergency Surgery), Fujian Medical University Union HospitalDepartment of General Surgery (Emergency Surgery), Fujian Medical University Union HospitalDepartment of General Surgery (Emergency Surgery), Fujian Medical University Union HospitalDepartment of General Surgery (Emergency Surgery), Fujian Medical University Union HospitalAbstract Background Nasointestinal tubes (NITs) have been increasingly used in patients with small bowel obstruction (SBO); However, severe adverse events (SAEs) of NITs might threaten the lives of patients. The indications of NITs need to be identified. This study was designed to explore the indications for the insertion of NITs in patients with SBO and to suggest the optimal strategies for individuals based on the outcomes of SAEs. Methods After propensity score matching, 68 pairs were included (Success group and failure group). The occurrence of SAEs and the clinical parameters were compared between the SAE group and the non-SAE group. Independent risk factors were evaluated among the subgroups. A novel scoring system was established to detect the subgroups that would benefit from NITs insertion. Results Successful implementation of NITs could avoid hypochloremia (p = 0.010), SAEs (p = 0.001), pneumonia (p = 0.006). SAEs occurred in 13 of 136 (9.6%) patients who accepted NITs insertion treatment. Risk factors for SAEs included tumors (p = 0.002), reduced BMI (p = 0.048), reduced hemoglobin (p = 0.001), abnormal activated partial thromboplastin time (p = 0.015) and elevated white blood cells (p = 0.002). A novel risk scoring system consists of hemoglobin before NITs insertion (95% CI 0.685, 0.893) and bowel obstruction symptoms relieved after NITs insertion (95% CI 0.575, 0.900) had the highest area under curve for predicting the occurrence of SAEs. We divided the risk score system into 3 grades, with the increasing grades, the rates of SAEs surged from 1.3% (1/74) to (6/11) 54.5%. Conclusion NITs successfully insertion could avoid SAEs occurrence in SBO conservative treatment. SBO patients without anemia and could be relieved after NITs insertion could be the potential benefit group for this therapy.https://doi.org/10.1186/s12876-022-02405-8Nasointestinal tubeSmall bowel obstructionIndicationSevere adverse eventsRisk score system |
| spellingShingle | Hui Wang Jun-rong Zhang Shuai Chen Ping Hou Qing-feng Chen Zong-qi Weng Xin-chang Shang-guan Bing-qiang Lin Xian-qiang Chen Who would avoid severe adverse events from nasointestinal tube in small bowel obstruction? A matched case–control study BMC Gastroenterology Nasointestinal tube Small bowel obstruction Indication Severe adverse events Risk score system |
| title | Who would avoid severe adverse events from nasointestinal tube in small bowel obstruction? A matched case–control study |
| title_full | Who would avoid severe adverse events from nasointestinal tube in small bowel obstruction? A matched case–control study |
| title_fullStr | Who would avoid severe adverse events from nasointestinal tube in small bowel obstruction? A matched case–control study |
| title_full_unstemmed | Who would avoid severe adverse events from nasointestinal tube in small bowel obstruction? A matched case–control study |
| title_short | Who would avoid severe adverse events from nasointestinal tube in small bowel obstruction? A matched case–control study |
| title_sort | who would avoid severe adverse events from nasointestinal tube in small bowel obstruction a matched case control study |
| topic | Nasointestinal tube Small bowel obstruction Indication Severe adverse events Risk score system |
| url | https://doi.org/10.1186/s12876-022-02405-8 |
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