Postoperative ileus and associated factors in patients following major abdominal surgery in Ethiopia: a prospective cohort study.

Abstract

Background: Postoperative ileus is a complication of abdominal surgery, resulting in significant morbidity and patient discomfort, dissatisfaction, and great economic burden. However, clinical studies regarding POI are very limited in Ethiopia and other Sub-Saharan countries. The main objective of this study is to assess the incidence and associated factors of postoperative ileus among adult patients who underwent abdominal surgery at hospitals in Northwest Ethiopia.

Methods and materials: A multicenter hospital-based prospective cohort study was conducted on patients who underwent major abdominal surgeries at specialized hospitals in Bahir Dar from November 20, 2023, to January 20, 2024. A total of 252 were selected by consecutive sampling techniques and included in the final analysis. Data were collected using EpidData version n4.6 and analyzed by STATA version 17. Bivariable and multivariable binary logistic regression were fitted to identify the explanatory variables.

Results: The incidence of postoperative ileus at hospitals in Bahir Dar was 16.27% (95% CI: 12.19%, 21.38%). Age > 60 years (adjusted odds ratio (AOR) = 3.81, 95% CI: 1.41, 10.33), BMI < 18.5 kg/m² (AOR = 11.54, 95% CI: 67.55), and intestinal surgery (AOR = 3.27, 95% CI: 1.01, 11.77) were significantly associated with postoperative ileus. On the other hand, being female was associated with a decreased likelihood of postoperative ileus (AOR = 61%, AOR = 0.39, 95% CI: 0.15, 0.97).

Conclusion: Postoperative ileus among patients who underwent major abdominal surgery in Bahir Dar was comparable with global reports. Old age, low body mass index, and intestinal surgeries were significant determinant factors for postoperative ileus. Being female is associated with a decreased likelihood of postoperative ileus.