Application of the AAST EGS Grade for Adhesive Small Bowel Obstruction to a Multi-national Patient Population

World Journal of Surgery
Matthew C HernandezMartin D Zielinski

Abstract

The American Association for the Surgery of Trauma (AAST) anatomic severity grading system for adhesive small bowel obstruction (ASBO) has demonstrated to be a valid tool in North American patient populations. Using a multi-national patient cohort, we retrospectively assessed the validity the AAST ASBO grading system and estimated disease severity in a global population in order to correlate with several key clinical outcomes. Multicenter retrospective review during 2012-2016 from four centers, Minnesota USA, Bologna Italy, Pietermaritzburg South Africa, and Bucharest Romania, was performed. Adult patients (age ≥ 18) with ASBO were identified. Baseline demographics, physiologic parameters, laboratory results, operative and imaging details, outcomes were collected. AAST ASBO grades were assigned by independent reviewers. Univariate and multivariable analyses with odds ratio (OR) and 95% confidence intervals (CIs) were performed. There were 789 patients with a median [IQR] age of 58 [40-75] years; 47% were female. The AAST ASBO grades were I (n = 180, 23%), II (n = 443, 56%), III (n = 87, 11%), and IV (n = 79, 10%). Successful non-operative management was 58%. Conversion rate from laparoscopy to laparotomy was 33%. Overall mortal...Continue Reading

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Citations

Sep 27, 2019·World Journal of Surgery·Matthew C HernandezMartin D Zielinski
Jan 25, 2020·The Journal of Trauma and Acute Care Surgery·Morgan E SindallAndrew C Bernard
Jun 12, 2019·BJS Open·M J LeeUNKNOWN NASBO steering group and NASBO collaborators
Jun 17, 2021·Current Problems in Surgery·David J DetzKevin Y Pei

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