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Clinical Trial Summary

Small bowel obstruction (SBO) and its complications are frequently seen in patients admitted through the Emergency Departments of all acute care hospitals2. There is variation in the optimal use of imaging, the appropriate timing and duration of non-operative management attempts, anti-microbial therapies, and the criteria for surgical management, which results in heterogeneity in approaches and outcomes across international clinical centers. The expected number of SBO cases in most clinical centers is predictable, enabling a suitably-sized cohort of patients to be gathered in the snapshot audit. This 'ESTES snapshot audit' -a prospective observational cohort study- has a dual purpose. Firstly, as an epidemiological study, it aims to uncover the burden of disease. Secondly, it aims to demonstrate current strategies employed to diagnose and treat these patients. These twin aims will serve to provide a 'snapshot' of current practice, but will also be hypothesis-generating while providing a rich source of patient-level data to allow further analysis of the particular clinical questions.


Clinical Trial Description

Prospective audit of consecutive patients admitted in Emergency Department for mechanical small bowel obstruction over a 3-month period. The audit shall include unscheduled patient admissions from November 2023 until May 2024 as outlined in 'Key Study Dates'. As this is an observational cohort audit, no change to normal patient management is required. Primary Objective To explore differences in patients, management and outcomes across the entire cohort to identify areas of practice variability resulting in apparent differences in outcome warranting further study. The outcomes that the study will examine are: - Incidence of small bowel obstruction by etiology. - Differences in clinical presentation. - Diagnostic work-up. - Non-operative management strategies. - Time to surgery and outcomes. - Complications related to disease and/or therapies within 60 post-operative days. - Length of Emergency Department and Hospital stay. - Re-admission within 6 months for related conditions. Methods for identifying patients Multiple methods may be used according to local circumstances/staffing: 1. Daily review of emergency department (non-operative) and operating room lists. 2. Daily review of team handover sheets / emergency admission lists / ward lists. 3. Review of operating room logbooks. 4. Use of electronic systems to flag any readmissions of patients identified and treated. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT05843097
Study type Observational
Source European Society for Trauma and Emergency Surgery
Contact Isidro Martínez Casas, MD PhD
Phone + 34 608412421
Email isidromartinez@me.com
Status Not yet recruiting
Phase
Start date November 1, 2023
Completion date September 1, 2024

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