Table 4.
Characteristics of patients with small bowel volvulus undergoing operative or nonoperative management.*
| Operative management | Non-operative management | P-value | |
|---|---|---|---|
| Total Patients | 13,486 (65.21%) | 7,194 (34.79%) | |
| Age, mean (sd), years | 63.8 (19.4) | 70.1 (18.6) | <0.0001 |
| Sex | 0.704 | ||
| Female | 7,638 (56.69%) | 4,058 (56.42%) | |
| Male | 5,835 (43.31%) | 3,135 (43.58%) | |
| Race | 0.001 | ||
| White | 7,925 (76.01%) | 4,242 (74.11%) | |
| Black | 1,370 (13.14%) | 848 (14.81%) | |
| Hispanic | 678 (6.50%) | 380 (6.64%) | |
| Asian or Pacific Islander | 211 (2.02%) | 88 (1.54%) | |
| Indian/Other | 242 (2.32%) | 166 (2.9%) | |
| Insurance | <0.0001 | ||
| Medicare | 7,374 (54.81%) | 4,881 (67.93%) | |
| Medicaid | 779 (5.79%) | 459 (6.39%) | |
| Private | 4,367 (32.46%) | 1,496 (20.82%) | |
| Self-pay | 569 (4.23%) | 193 (2.69%) | |
| No charge | 49 (0.36%) | 16 (0.22%) | |
| Other | 316 (2.35%) | 140 (1.95%) | |
| Charlson Comorbidity Index | <0.0001 | ||
| 0 | 7,502 (55.63%) | 3,099 (43.08%) | |
| 1-2 | 4,147 (30.75%) | 2,653 (36.88%) | |
| ≥3 | 1,837 (13.62%) | 1,442 (20.04%) | |
| Presentation | <0.0001 | ||
| Elective | 1,149 (58.38%) | 819 (41.62%) | |
| Emergent | 10,836 (90.41%) | 5,486 (87.01%) | |
| Hospital Type | |||
| Teaching | 5,509 (40.09%) | 2,758 (38.48%) | <0.0001 |
| Rural | 2,223 (16.48%) | 1,396 (19.41%) | <0.0001 |
| Urban | 11,263 (83.52%) | 5,798 (80.59%) | <0.0001 |
| Management | |||
| Laparoscopic | 855 (6.34%) | ||
| Adhesiolysis | 6,709 (32.44%) | ||
| Small bowel resection | 4,954 (23.96%) | ||
| Manipulation | 2,763 (12.26%) | ||
| Dilation | 2,451 (11.85%) | ||
| Small bowel surgery | 2,021 (9.77%) | ||
| Destruction of peritoneal tissue | 888 (4.29%) | ||
| Exploratory laparotomy | 544 (2.63%) | ||
| Ladds | 72 (0.53%) | ||
| Small bowel pexy | 68 (0.33%) | ||
| Presentations of acute abdomen | |||
| Acute vascular insufficiency | 3,210 (23.80%) | 300 (4.17%) | <0.0001 |
| Peritonitis | 543 (4.03%) | 96 (1.33%) | <0.0001 |
| Coagulopathy | 177 (1.31%) | 88 (1.22%) | 0.587 |
| Malrotation | 134 (0.99%) | 35 (0.49%) | <0.0001 |
| Pneumoperitoneum | 74 (0.55%) | 11 (0.15%) | <0.0001 |
| Mortality | |||
| In-hospital mortality | 800 (5.94%) | 837 (11.65%) | <0.0001 |
| Admission to death time, mean (sd), days | 10.2 (12.8) | 6.1 (10.0) | <0.0001 |
*
Percentages are based upon the denominator of available data.