ArticleAnnals of African medicine2026
Predictors of Mortality and Modern Surgical Strategies in Intestinal Obstruction: A 200-Patient Study from a North Indian Tertiary Center.
Article in Annals of African medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIntestinal obstruction remains a common surgical emergency associated with considerable morbidity and mortality, especially in low- and middle-income countries. The evolving epidemiology, emergence of postoperative adhesions as a leading cause, and adoption of modern surgical practices necessitate updated real-world analyses. MATERIALS AND
methodsA retrospective study was conducted on 200 patients who underwent surgical management for intestinal obstruction at Indraprastha Apollo Hospitals, New Delhi, India, between January 2018 and December 2023. Demographic, clinical, radiologic, intraoperative, and outcome data were collected. Multivariate logistic regression was used to identify the independent predictors of in-hospital mortality.
resultsPostoperative adhesions (32%) and external hernias (18%) were the most common causes of obstruction. Abdominal pain (100%), vomiting (94%), and distension (88%) were the predominant presenting symptoms. Computed tomography (CT) scans were performed in 35% of cases and led to changes in surgical planning in over 60% of those patients. Surgical interventions included adhesiolysis (32%), hernia repair (18%), bowel resection with anastomosis (24%), and stoma creation (9%). The overall in-hospital mortality rate was 7%. On multivariate analysis, the significant predictors of mortality were strangulated obstruction (OR 5.2, P = 0.002), delayed presentation >48 h (OR 3.8, P = 0.02), and presence of peritonitis (OR 2.9, P = 0.03). Partial enhanced recovery after surgery implementation in 48% of patients was associated with shorter hospital stay and fewer infectious complications.
conclusionThis large single-center study identifies the key predictors of mortality and highlights the practical role of CT imaging and enhanced recovery protocols in the surgical management of intestinal obstruction. Early referral, timely surgical intervention, and protocol-driven care are essential to improve the outcomes in resource-constrained settings.
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