Incidence and clinical predictors of postoperative ileus following non-abdominal surgery in Ethiopia: a prospective cohort study.

Abstract

Background: Postoperative ileus (POI) is a common consequence following abdominal surgeries; however, its incidence and risk factors in non-abdominal procedures remain unknown. Identifying clinical indicators of POI in this population is essential for early detection and treatment.

Objective: This study aims to assess the incidence and determinants of postoperative ileus (POI) in patients undergoing non-abdominal surgeries at Debre Tabor Comprehensive Specialized Hospital.

Methods: A prospective cohort study was conducted between September 1, 2024, and January 30, 2025. Demographic characteristics, comorbidities, surgical details, and perioperative parameters were recorded. Data were analyzed using SPSS version 27, with continuous and categorical variables summarized using descriptive statistics. Independent predictors of postoperative ileus (POI) were identified through bivariate and multivariate logistic regression analyses.

Results: Among the 400 patients who underwent elective non-abdominal surgery, 31 (7.75%) developed postoperative ileus (POI). Significant predictors included opioid use (OR = 3.28 [95% CI, 2.25-7.12], P < 0.01), neuromuscular blockers (OR = 2.33 [95% CI, 2.01-5.12], P < 0.01), poor postoperative functional status (OR = 5.67 [95% CI, 3.41-8.91], P < 0.01), and delayed postoperative mobility (OR = 4.45 [95% CI, 2.05-8.17], P < 0.01).

Recommendation and conclusion: POI occurs in a significant proportion of patients undergoing non-abdominal surgery. Implementing targeted perioperative strategies may reduce the incidence of POI and enhance postoperative outcomes.