Exposing the incidence of ileus in pelvic and acetabular fractures: a retrospective case analysis |
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| Institution: | 1. Orthopedic Trauma Surgeon, Department of Orthopedic Trauma, Nottingham University Hospitals, Nottingham, UK;2. Chief of Orthopedic Trauma, Detroit Medical Center, Professor of Orthopedics, Wayne State University, 9B University Health Center, Detroit Receiving Hospital, 4201 St. Antoine Boulevard, Detroit, MI, 48201 United States;3. Professor of Orthopedics, 0490 McCaig Tower, Foothills Medical Center 3134 Hospital Dr NW Calgary, Alberta, T2N 5A1 Canada;1. Department of Orthopedic Surgery, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA;2. R Adams Cowley Shock Trauma Center, Department of Orthopedics, University of Maryland, Baltimore, MD, USA;1. Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA USA;2. Department of Orthopaedic Surgery, UTHealth McGovern Medical School, Houston, TX USA;1. Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria;2. Department of Orthopedics and Trauma, Paracelsus Medical University. Address: Müllner Hauptstraße 48, 5020 Salzburg, Austria;3. AUVA Trauma Hospital Styria, Graz. Address: Göstinger Str. 24, 8020 Graz, Austria;4. Department of Ophthalmology, Medical University of Vienna. Address: Währinger Gürtel 18-20, 1090 Vienna, Austria;5. Clinic for Trauma Surgery, Orthopedics and Hand Surgery, Klinikum Wolfsburg. Address: Sauerbruchstraße 7, 38440 Wolfsburg, Germany;6. Department of Trauma Surgery, State Hospital Feldbach-Fürstenfeld. Address: Ottokar-Kernstock-Straße 18, 8330 Feldbach, Austria |
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| Abstract: | BackgroundParalytic ileus is a temporary inhibition of gastrointestinal mobility in the absence of mechanical obstruction. Ileus has previously been observed in up to 40% of patients undergoing bowel surgery, leading to increased morbidity and length of stay. Pelvic and acetabular fractures are often caused by high energy trauma and are associated with a risk of visceral injury. Prior to this study, there were no reported figures for the incidence of ileus in patients presenting with pelvic and/or acetabular fractures.MethodsAll patients over the age of 16 presenting to a major trauma centre throughout 2019 were included. Data collected included patient demographics, injury pattern, fracture management and presence of ileus. As in previous studies, patients were identified as having ileus if they failed to tolerate an oral diet and open their bowels for more than three days (GI-2). Analysis assessed risk factors for ileus as well as its effect on length of stay.ResultsAn incidence of ileus of 40.35% was observed in the 57 included patients. Across all patients, ileus was three times more common in patients with a diagnosis of diabetes mellitus (p= 0.56) and 2.5 times more common in the presence of an open pelvic/ acetabular fracture (p= 0.73). Length of stay was significantly longer in patients under 65 years identified as having ileus (p= 0.046). Gender, age, opiate use, fracture management and surgical approach were not identified as risk factors for ileus.Conclusion/ FindingsThis is the first study to report the incidence of and risk factors for ileus following admission with pelvic and/or acetabular fractures. Due to the morbidity and cost associated with this condition, further research is required to assess the effect of interventions to reduce its incidence in this patient subgroup. |
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