Zamknięcie jelit – Rokowania, prognozy i postęp choroby

Zamknięcie jelit
Rokowania, prognozy i postęp choroby

Zamknięcie jelit, w tym złośliwa niedrożność jelit (MBO), stanowi istotny czynnik pogarszający rokowanie pacjentów, zwłaszcza z rakiem jelita grubego, gdzie 3-letni wskaźnik przeżycia wynosi 48,3% (95% CI, 43,9-52,8) u pacjentów z niedrożnością w porównaniu do 54,9% (95% CI, 53,1-56,6) bez niej. Po dostosowaniu do innych zmiennych, niedrożność jelit wiąże się ze skorygowanym współczynnikiem ryzyka 1,22 (p=0,008) oraz 1,19-krotnie wyższym ryzykiem zgonu. Kluczowe czynniki prognostyczne obejmują m.in. chemioradioterapię (HR=0,29), leczenie zachowawcze (HR=3,81), stopień zaawansowania T4 wg AJCC (HR=8,64), liczbę erytrocytów (HR=0,53), czas protrombinowy (HR=1,45), poziom AST (HR=1,01) oraz obecność martwicy jelita (HR=5,62). Modele prognostyczne wykazują wysoką skuteczność w przewidywaniu przeżycia 30-, 90- i 180-dniowego (AUC odpowiednio 0,87, 0,94, 0,92), co umożliwia optymalizację strategii terapeutycznych.

Prognostyczne aspekty zamknięcia jelit

Prognoza przy nowotworowej niedrożności jelit
Czynniki ryzyka w prognozowaniu złośliwej niedrożności jelit
Modele prognostyczne dla niedrożności jelit
Prognoza w zaciśniętej niedrożności jelit
Prognoza po leczeniu operacyjnym niedrożności jelit

Znaczenie modeli prognostycznych w praktyce klinicznej

Kolejne rozdziały

Prognostyczne aspekty zamknięcia jelit

Zamknięcie jelit (niedrożność jelit) stanowi poważny stan kliniczny, który w znaczący sposób wpływa na rokowanie pacjentów. Precyzyjne określenie prognozy pacjentów z niedrożnością jelit jest kluczowe dla optymalizacji strategii leczniczych oraz poprawy wyników klinicznych.¹ Ocena prognostyczna niedrożności jelit wymaga uwzględnienia wielu czynników, w tym etiologii niedrożności, czasu od wystąpienia objawów do podjęcia leczenia, wieku pacjenta oraz chorób współistniejących.²

Prognoza przy nowotworowej niedrożności jelit

Złośliwa niedrożność jelit (MBO – Malignant Bowel Obstruction) znacząco pogarsza jakość życia i rokowanie pacjentów onkologicznych.³ W przypadku raka jelita grubego, obecność niedrożności jelit jest istotnym negatywnym czynnikiem prognostycznym. Badania wykazały, że pacjenci z rakiem jelita grubego i współistniejącą niedrożnością mają istotnie gorsze rokowanie w porównaniu do pacjentów bez niedrożności.⁴

Analizy wskaźników przeżycia wykazały, że:⁵⁶

3-letni wskaźnik przeżycia po leczeniu wynosił 48,3% (95% CI, 43,9-52,8) u pacjentów z niedrożnością jelit (n=593) w porównaniu do 54,9% (95% CI, 53,1-56,6) u pacjentów bez niedrożności (n=3,908)
5-letni wskaźnik przeżycia dla pacjentów z niedrożnością wynosił 37,3% (95% CI, 31,9-42,8), co było niższe niż u pacjentów bez niedrożności jelit (45,6%; 95% CI, 43,5-47,7)
Po dostosowaniu współczynnika ryzyka do innych zmiennych prognostycznych, niedrożność jelit wykazała statystycznie istotną negatywną korelację ze wskaźnikiem przeżycia pacjentów z rakiem jelita grubego, ze skorygowanym współczynnikiem ryzyka 1,22 (p=0,008)

Mediana czasu przeżycia u pacjentów bez niedrożności jelit była dłuższa niż u pacjentów z niedrożnością. Ryzyko zgonu z powodu raka jelita grubego było 1,19 razy wyższe u pacjentów z niedrożnością jelit w porównaniu do tych bez niedrożności.⁷

Czynniki ryzyka w prognozowaniu złośliwej niedrożności jelit

Badania zidentyfikowały kluczowe czynniki ryzyka wpływające na śmiertelność pacjentów z MBO. Do najważniejszych należą:⁸⁹

Chemioradioterapia (β = -1,24; HR = 0,29; 95% CI, 0,14-0,59) – czynnik obniżający ryzyko zgonu
Leczenie zachowawcze (β = 1,34; HR = 3,81; 95% CI, 1,69-8,55) – czynnik zwiększający ryzyko zgonu
Nowe przypadki (β = -0,96; HR = 0,38; 95% CI, 0,19-0,77) – czynnik obniżający ryzyko zgonu
Stopień zaawansowania T4 wg AJCC (β = 2,16; HR = 8,64; 95% CI, 1,47-50,76) – istotny czynnik zwiększający ryzyko zgonu
Liczba czerwonych krwinek (RBC, β = -0,63; HR = 0,53; 95% CI, 0,38-0,80) – czynnik obniżający ryzyko zgonu
Czas protrombinowy (PT, β = 0,37; HR = 1,45; 95% CI, 1,07-1,97) – czynnik zwiększający ryzyko zgonu
Aminotransferaza asparaginianowa (AST, β = 0,01; HR = 1,01; 95% CI, 1,00-1,02) – czynnik zwiększający ryzyko zgonu
Martwica jelita (β = 1,73; HR = 5,62; 95% CI, 1,11-28,27) – bardzo istotny czynnik zwiększający ryzyko zgonu

Modele prognostyczne dla niedrożności jelit

Opracowano i zwalidowano modele prognostyczne dla pacjentów z niedrożnością jelit, które mogą pomóc w przewidywaniu przeżycia pacjentów i optymalizacji strategii leczenia.¹⁰ Modele te wykazały wysoką skuteczność w przewidywaniu 30-dniowego, 90-dniowego i 180-dniowego przeżycia pacjentów z MBO.¹¹

W grupie rozwojowej modelu prognostycznego, wartości AUC i C-index dla prognozowania 30-dniowego, 90-dniowego i 180-dniowego przeżycia wynosiły odpowiednio 0,87, 0,94 i 0,92.¹² Analiza DCA (Decision Curve Analysis) potwierdziła wiarygodność modelu i jego skuteczność w przewidywaniu okresów przeżycia pacjentów z MBO.¹³ Wszystkie wartości C-index i AUC są większe niż lub zbliżone do 0,9, co wskazuje na doskonałą przewidywalność i dokładność modelu.¹⁴

Prognoza w zaciśniętej niedrożności jelit

Zaciśnięta niedrożność jelit (StIO – Strangulated Intestinal Obstruction) wiąże się ze znacznie gorszym rokowaniem w porównaniu do prostej niedrożności jelit. Wskaźnik śmiertelności związany z StIO może osiągnąć 20-30%, a w przypadkach martwicy pełnościennej jelita gwałtownie wzrasta do 50%.¹⁵

Szybka interwencja chirurgiczna jest kluczowa w StIO, aby złagodzić niedrożność, przywrócić przepływ krwi w jelitach i zapobiec martwicy oraz perforacji. Opóźnienia w interwencji chirurgicznej mogą dodatkowo pogorszyć wskaźniki śmiertelności o 20-40%.¹⁶

Opracowano i zwizualizowano skuteczny kliniczny model predykcji ryzyka dla StIO oparty na następujących czynnikach:¹⁷

Odsetek neutrofili (NEUT%)
Poziom albuminy (ALB)
Objawy podrażnienia otrzewnej
Obecność płynu w jamie brzusznej

Prognoza po leczeniu operacyjnym niedrożności jelit

Pomimo potencjału ratującego życie, operacja niedrożności jelit wiąże się z wysokim ryzykiem zgonu podczas zabiegu lub krótko po nim.¹⁸ Badania wskazują, że:¹⁹

Około 5% do 30% osób z niedrożnością jelita cienkiego umiera w ciągu 30 dni
Wskaźnik śmiertelności dla niedrożności jelita grubego wynosi między 10% a 20%

W badaniu z 2016 roku stwierdzono, że 30-dniowe i 90-dniowe wskaźniki śmiertelności dla 323 osób poddanych pilnej laparotomii z powodu niedrożności jelita cienkiego wynosiły odpowiednio 13% i 17%.²⁰ Ponadto, u 28% pacjentów wystąpiły poważne powikłania w ciągu 30 dni.²¹

Wpływ wieku i płci na prognozę

Prawdopodobieństwo zgonu po operacji niedrożności jelit jest niższe u młodszych pacjentów.²² W badaniu z 2022 roku analizowano wskaźnik przeżycia osób w wieku 40-74 lat i osób powyżej 75 roku życia leczonych z powodu niedrożności jelit w latach 2009-2019.²³ Wyniki wykazały, że:²⁴

Osoby z młodszej grupy miały wewnątrzszpitalny wskaźnik śmiertelności na poziomie 8,9% w porównaniu do 18,2% dla osób ze starszej grupy
Każdy wzrost wieku o 10 lat był związany z 30% wyższym ryzykiem zgonu w ciągu 30 dni od operacji

Badania z 2021 roku wykazały również, że wskaźnik śmiertelności operacji niedrożności jelit był znacznie wyższy u kobiet niż u mężczyzn powyżej 65 roku życia. Wskaźnik śmiertelności wynosił 10,6% u kobiet i 2,6% u mężczyzn.²⁵

Wpływ czasu rozpoczęcia leczenia na prognozę

Oprócz wieku, jednym z najważniejszych czynników determinujących szanse przeżycia operacji niedrożności jelit jest czas rozpoczęcia leczenia.²⁶ Badania wykazały, że ogólny wskaźnik śmiertelności w ciągu 30 dni wynosił 7,2%. Operacja opóźniona o ponad 72 godziny wiązała się z 39% wyższym ryzykiem zgonu w ciągu 30 dni.²⁷

Czynniki związane z najwyższym ryzykiem zgonu obejmowały:²⁸

Słabą wydolność fizyczną
Choroby metaboliczne
Obturacyjną chorobę płuc
Konieczność transfuzji krwi podczas operacji

Operacja niedrożności jelit wiąże się z wysokim ryzykiem powikłań i zgonu, co podkreśla znaczenie szybkiej diagnozy i odpowiedniego leczenia.²⁹

Znaczenie modeli prognostycznych w praktyce klinicznej

Dokładne oszacowanie rokowania pacjentów z niedrożnością jelit ma kluczowe znaczenie dla formułowania racjonalnych planów leczenia, poprawy jakości życia pacjentów i wydłużenia czasu ich przeżycia.³⁰ Modele prognostyczne opracowane na podstawie obiektywnych czynników klinicznych mogą dostarczyć lekarzom wiarygodnych danych do podejmowania decyzji klinicznych i opracowywania spersonalizowanych planów leczenia.³¹³²

Skuteczne modele prognostyczne dla MBO są szczególnie istotne, ponieważ stan ten jest złożonym problemem klinicznym, który poważnie wpływa na jakość życia i rokowanie pacjentów. Obecny brak skutecznych modeli prognostycznych dla MBO znacznie ograniczył precyzyjne leczenie kliniczne i zarządzanie pacjentami.³³³⁴

Wczesna i dokładna identyfikacja pacjentów z zaciśniętą niedrożnością jelit (StIO), a następnie szybka interwencja chirurgiczna w celu złagodzenia niedrożności, ma kluczowe znaczenie dla poprawy wyników leczenia pacjentów.³⁵ Opracowany nomogram do przewidywania ryzyka StIO wykazał dobrą skuteczność w odróżnianiu prostej niedrożności jelit od StIO, ułatwiając wczesne przewidywanie i identyfikację pacjentów z wysokim ryzykiem StIO.³⁶

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Materiały źródłowe

#1 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study | Scientific Reports
https://www.nature.com/articles/s41598-025-96593-4
The results of DCA analysis indicated that the model was reliable and could effectively predict the 30 – day, 90 – day, and 180 – day survival periods of MBO patients. […] This model identified multiple key prognostic factors and exhibited good predictive performance. […] It provides important reference for clinicians to predict the survival period of MBO patients and develop personalized treatment plans, and is expected to improve the clinical outcomes of MBO patients. […] Therefore, accurately assessing the prognosis of patients with malignant bowel obstruction is crucial for formulating reasonable treatment plans, improving the quality of life of patients, and prolonging their survival time. […] The model established in this study is of great significance. […] According to the model validation results, all C – index and AUC values are greater than or close to 0.9, indicating that the model has excellent predictability and accuracy. […] This means that the model can predict the survival of patients relatively stably on different data sets and provide a reliable basis for clinical decision – making.
#2 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study – PubMed
https://pubmed.ncbi.nlm.nih.gov/40185941/
Malignant bowel obstruction (MBO) is a common and complex condition in clinical practice, which seriously affects the quality of life and prognosis of patients. […] However, the current lack of effective prognostic models for MBO has greatly limited clinical precision treatment and patient management. […] This study aims to construct and validate a prognostic model for the overall survival (OS) of MBO patients, providing crucial support for clinical decision-making and improving the prognosis of patients. […] The study found that significant risk factors affecting patient mortality included chemoradiotherapy ( = – 1.24; HR = 0.29;95%CI, 0.14-0.59), conservative treatment ( = 1.34; HR = 3.81; 95%CI, 1.69-8.55), new cases ( = – 0.96; HR = 0.38; 95%CI, 0.19-0.77), AJCC T stage 4 ( = 2.16; HR = 8.64; 95%CI, 1.47-50.76), red blood cell count (RBC, = – 0.63; HR = 0.53; ; 95%CI, 0.38-0.80), prothrombin time (PT, = 0.37; HR = 1.45; ; 95%CI, 1.07-1.97), aspartate aminotransferase (AST, = 0.01; HR = 1.01; 95%CI, 1.00-1.02), and intestinal necrosis ( = 1.73; HR = 5.62; 95%CI, 1.11-28.27).
#3 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study – PubMed
https://pubmed.ncbi.nlm.nih.gov/40185941/
Malignant bowel obstruction (MBO) is a common and complex condition in clinical practice, which seriously affects the quality of life and prognosis of patients. […] However, the current lack of effective prognostic models for MBO has greatly limited clinical precision treatment and patient management. […] This study aims to construct and validate a prognostic model for the overall survival (OS) of MBO patients, providing crucial support for clinical decision-making and improving the prognosis of patients. […] The study found that significant risk factors affecting patient mortality included chemoradiotherapy ( = – 1.24; HR = 0.29;95%CI, 0.14-0.59), conservative treatment ( = 1.34; HR = 3.81; 95%CI, 1.69-8.55), new cases ( = – 0.96; HR = 0.38; 95%CI, 0.19-0.77), AJCC T stage 4 ( = 2.16; HR = 8.64; 95%CI, 1.47-50.76), red blood cell count (RBC, = – 0.63; HR = 0.53; ; 95%CI, 0.38-0.80), prothrombin time (PT, = 0.37; HR = 1.45; ; 95%CI, 1.07-1.97), aspartate aminotransferase (AST, = 0.01; HR = 1.01; 95%CI, 1.00-1.02), and intestinal necrosis ( = 1.73; HR = 5.62; 95%CI, 1.11-28.27).
#4 Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma?
https://pmc.ncbi.nlm.nih.gov/articles/PMC4459110/
The goal of this study was to assess the relationship between intestinal obstruction and the prognosis of colorectal carcinoma. […] Intestinal obstruction was reported in more than 13% of patients. The 3-year survival rate after treatment was 48.3% for patients with intestinal obstruction and 54.9% for patients without intestinal obstruction. The 5-year survival rate for patients with intestinal obstruction was 37.3%, which was lower than that of patients without intestinal obstruction. After adjusting the hazard ratio for other prognostic variables, intestinal obstruction had a statistically significant negative correlation with the survival rate of colorectal cancer patients, with an adjusted hazard ratio of 1.22. […] The presence of intestinal obstruction is associated with a lower survival rate among colorectal cancer patients.
#5 Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma?
https://pmc.ncbi.nlm.nih.gov/articles/PMC4459110/
The Kaplan-Meier estimates of the 3-year survival rate after treatment were 48.3% for patients with intestinal obstruction and 54.9% for patients without intestinal obstruction. The 5-year survival rate for patients with intestinal obstruction was 37.3%, which was lower than that of patients without intestinal obstruction. The analysis revealed that intestinal obstruction had a significant negative effect on colorectal carcinoma survival. Specifically, the risk of colorectal carcinoma death was 1.19 times higher for patients with intestinal obstruction compared to those without intestinal obstruction. After adjusting the hazard ratio for other prognostic variables, intestinal obstruction among colorectal cancer patients was found to be a statistically significant factor for poor survival, with an adjusted hazard ratio of 1.22.
#6 Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma?
https://www.e-epih.org/journal/view.php?number=783
OBJECTIVES: The goal of this study was to assess the relationship between intestinal obstruction and the prognosis of colorectal carcinoma. […] RESULTS: Intestinal obstruction was reported in more than 13% of patients. The 3-year survival rate after treatment was 48.3% (95% confidence interval [CI], 43.9 to 52.8) for patients with intestinal obstruction (n=593) and 54.9% (95% CI, 53.1 to 56.6) for patients without intestinal obstruction (n=3,908). The 5-year survival rate for patients with intestinal obstruction was 37.3% (95% CI, 31.9 to 42.8), which was lower than that of patients without intestinal obstruction (45.6%; 95% CI, 43.5 to 47.7). After adjusting the hazard ratio for other prognostic variables, intestinal obstruction had a statistically significant negative correlation with the survival rate of colorectal cancer patients, with an adjusted hazard ratio of 1.22 (p=0.008). […] CONCLUSIONS: The presence of intestinal obstruction is associated with a lower survival rate among colorectal cancer patients.
#7 Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma?
https://pmc.ncbi.nlm.nih.gov/articles/PMC4459110/
The current study determined that the patients without intestinal obstruction in our cohort had a longer median survival time than those with intestinal obstruction. Patients with intestinal obstruction had a 3-year survival rate of 48.3%, compared to a 3-year survival rate of 54.9% in patients without intestinal obstruction. The 5-year survival rate of patients with intestinal obstruction was 37.3%, which was lower than that of patients without intestinal obstruction. Furthermore, the adjusted hazard ratio for death from colorectal carcinoma was 1.22 times higher in patients with intestinal obstruction, compared to those without intestinal obstruction. […] In conclusion, colorectal cancer patients without intestinal obstruction showed a tendency to live longer than those with intestinal obstruction, and the difference between the two groups was significant.
#8 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study – PubMed
https://pubmed.ncbi.nlm.nih.gov/40185941/
Malignant bowel obstruction (MBO) is a common and complex condition in clinical practice, which seriously affects the quality of life and prognosis of patients. […] However, the current lack of effective prognostic models for MBO has greatly limited clinical precision treatment and patient management. […] This study aims to construct and validate a prognostic model for the overall survival (OS) of MBO patients, providing crucial support for clinical decision-making and improving the prognosis of patients. […] The study found that significant risk factors affecting patient mortality included chemoradiotherapy ( = – 1.24; HR = 0.29;95%CI, 0.14-0.59), conservative treatment ( = 1.34; HR = 3.81; 95%CI, 1.69-8.55), new cases ( = – 0.96; HR = 0.38; 95%CI, 0.19-0.77), AJCC T stage 4 ( = 2.16; HR = 8.64; 95%CI, 1.47-50.76), red blood cell count (RBC, = – 0.63; HR = 0.53; ; 95%CI, 0.38-0.80), prothrombin time (PT, = 0.37; HR = 1.45; ; 95%CI, 1.07-1.97), aspartate aminotransferase (AST, = 0.01; HR = 1.01; 95%CI, 1.00-1.02), and intestinal necrosis ( = 1.73; HR = 5.62; 95%CI, 1.11-28.27).
#9 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study | Scientific Reports
https://www.nature.com/articles/s41598-025-96593-4
Malignant bowel obstruction (MBO) is a common and complex condition in clinical practice, which seriously affects the quality of life and prognosis of patients. […] However, the current lack of effective prognostic models for MBO has greatly limited clinical precision treatment and patient management. […] This study successfully constructed and validated a prognostic model for the overall survival of MBO patients. […] The study found that significant risk factors affecting patient mortality included chemoradiotherapy, conservative treatment, new cases, AJCC T stage 4, red blood cell count, prothrombin time, aspartate aminotransferase, and intestinal necrosis. […] In the development set, the AUC and C – index values of the prognostic models for 30 – day, 90 – day, and 180 – day are 0.87, 0.94, and 0.92 respectively.
#10 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study | Scientific Reports
https://www.nature.com/articles/s41598-025-96593-4
The results of DCA analysis indicated that the model was reliable and could effectively predict the 30 – day, 90 – day, and 180 – day survival periods of MBO patients. […] This model identified multiple key prognostic factors and exhibited good predictive performance. […] It provides important reference for clinicians to predict the survival period of MBO patients and develop personalized treatment plans, and is expected to improve the clinical outcomes of MBO patients. […] Therefore, accurately assessing the prognosis of patients with malignant bowel obstruction is crucial for formulating reasonable treatment plans, improving the quality of life of patients, and prolonging their survival time. […] The model established in this study is of great significance. […] According to the model validation results, all C – index and AUC values are greater than or close to 0.9, indicating that the model has excellent predictability and accuracy. […] This means that the model can predict the survival of patients relatively stably on different data sets and provide a reliable basis for clinical decision – making.
#11 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study – PubMed
https://pubmed.ncbi.nlm.nih.gov/40185941/
The results of DCA analysis indicated that the model was reliable and could effectively predict the 30-day, 90-day, and 180-day survival periods of MBO patients. […] This study successfully constructed and validated a prognostic model for the overall survival of MBO patients. […] It provides important reference for clinicians to predict the survival period of MBO patients and develop personalized treatment plans, and is expected to improve the clinical outcomes of MBO patients.
#12 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study | Scientific Reports
https://www.nature.com/articles/s41598-025-96593-4
Malignant bowel obstruction (MBO) is a common and complex condition in clinical practice, which seriously affects the quality of life and prognosis of patients. […] However, the current lack of effective prognostic models for MBO has greatly limited clinical precision treatment and patient management. […] This study successfully constructed and validated a prognostic model for the overall survival of MBO patients. […] The study found that significant risk factors affecting patient mortality included chemoradiotherapy, conservative treatment, new cases, AJCC T stage 4, red blood cell count, prothrombin time, aspartate aminotransferase, and intestinal necrosis. […] In the development set, the AUC and C – index values of the prognostic models for 30 – day, 90 – day, and 180 – day are 0.87, 0.94, and 0.92 respectively.
#13 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study | Scientific Reports
https://www.nature.com/articles/s41598-025-96593-4
The results of DCA analysis indicated that the model was reliable and could effectively predict the 30 – day, 90 – day, and 180 – day survival periods of MBO patients. […] This model identified multiple key prognostic factors and exhibited good predictive performance. […] It provides important reference for clinicians to predict the survival period of MBO patients and develop personalized treatment plans, and is expected to improve the clinical outcomes of MBO patients. […] Therefore, accurately assessing the prognosis of patients with malignant bowel obstruction is crucial for formulating reasonable treatment plans, improving the quality of life of patients, and prolonging their survival time. […] The model established in this study is of great significance. […] According to the model validation results, all C – index and AUC values are greater than or close to 0.9, indicating that the model has excellent predictability and accuracy. […] This means that the model can predict the survival of patients relatively stably on different data sets and provide a reliable basis for clinical decision – making.
#14 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study | Scientific Reports
https://www.nature.com/articles/s41598-025-96593-4
The results of DCA analysis indicated that the model was reliable and could effectively predict the 30 – day, 90 – day, and 180 – day survival periods of MBO patients. […] This model identified multiple key prognostic factors and exhibited good predictive performance. […] It provides important reference for clinicians to predict the survival period of MBO patients and develop personalized treatment plans, and is expected to improve the clinical outcomes of MBO patients. […] Therefore, accurately assessing the prognosis of patients with malignant bowel obstruction is crucial for formulating reasonable treatment plans, improving the quality of life of patients, and prolonging their survival time. […] The model established in this study is of great significance. […] According to the model validation results, all C – index and AUC values are greater than or close to 0.9, indicating that the model has excellent predictability and accuracy. […] This means that the model can predict the survival of patients relatively stably on different data sets and provide a reliable basis for clinical decision – making.
#15 Development and validation of a nomogram model to predict the risk of strangulated intestinal obstruction | Scientific Reports
https://www.nature.com/articles/s41598-024-82131-1
To develop and validate a nomogram model for discriminating simple intestinal obstruction and strangulated intestinal obstruction, thus providing objective evidence for clinical decision-making. […] The mortality rate associated with StIO can reach 20-30%. Notably, in cases of bowel transmural necrosis, this mortality rate dramatically increases to 50%. […] Therefore, prompt surgical intervention is crucial in StIO to alleviate the obstruction, restore intestinal blood flow, and prevent necrosis and perforation. […] Delays in surgical intervention can further worsen mortality rates by 20-40%. Therefore, early and accurate identification of StIO, followed by prompt surgical intervention to relieve the obstruction, is critical for improving patient outcomes. […] This study developed and visualized an effective clinical risk prediction model for StIO based on NEUT%, ALB, peritoneal irritation signs, and the presence of abdominal fluid. The nomogram exhibited good discrimination, calibration, and clinical usefulness, facilitating the early prediction and identification of patients at high risk of StIO.
#16 Development and validation of a nomogram model to predict the risk of strangulated intestinal obstruction | Scientific Reports
https://www.nature.com/articles/s41598-024-82131-1
To develop and validate a nomogram model for discriminating simple intestinal obstruction and strangulated intestinal obstruction, thus providing objective evidence for clinical decision-making. […] The mortality rate associated with StIO can reach 20-30%. Notably, in cases of bowel transmural necrosis, this mortality rate dramatically increases to 50%. […] Therefore, prompt surgical intervention is crucial in StIO to alleviate the obstruction, restore intestinal blood flow, and prevent necrosis and perforation. […] Delays in surgical intervention can further worsen mortality rates by 20-40%. Therefore, early and accurate identification of StIO, followed by prompt surgical intervention to relieve the obstruction, is critical for improving patient outcomes. […] This study developed and visualized an effective clinical risk prediction model for StIO based on NEUT%, ALB, peritoneal irritation signs, and the presence of abdominal fluid. The nomogram exhibited good discrimination, calibration, and clinical usefulness, facilitating the early prediction and identification of patients at high risk of StIO.
#17 Development and validation of a nomogram model to predict the risk of strangulated intestinal obstruction | Scientific Reports
https://www.nature.com/articles/s41598-024-82131-1
To develop and validate a nomogram model for discriminating simple intestinal obstruction and strangulated intestinal obstruction, thus providing objective evidence for clinical decision-making. […] The mortality rate associated with StIO can reach 20-30%. Notably, in cases of bowel transmural necrosis, this mortality rate dramatically increases to 50%. […] Therefore, prompt surgical intervention is crucial in StIO to alleviate the obstruction, restore intestinal blood flow, and prevent necrosis and perforation. […] Delays in surgical intervention can further worsen mortality rates by 20-40%. Therefore, early and accurate identification of StIO, followed by prompt surgical intervention to relieve the obstruction, is critical for improving patient outcomes. […] This study developed and visualized an effective clinical risk prediction model for StIO based on NEUT%, ALB, peritoneal irritation signs, and the presence of abdominal fluid. The nomogram exhibited good discrimination, calibration, and clinical usefulness, facilitating the early prediction and identification of patients at high risk of StIO.
#18 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Despite being potentially lifesaving, bowel obstruction surgery is associated with a high rate of death during surgery or shortly after the procedure. […] If left untreated, bowel obstruction can be life threatening. Emergency surgery may be needed to fix whatever is causing the blockage. […] People who require emergency bowel obstruction surgery tend to have a relatively high chance of death or complications either during surgery or shortly after. […] About 5% to 30% of people with small intestinal obstruction die within 30 days, according to a 2022 study. The rate is between 10% and 20% for large bowel obstruction. […] In a 2016 study, researchers found that the 30-day and 90-day mortality rates for 323 people undergoing emergency laparotomy for small bowel obstruction were 13% and 17%, respectively.
#19 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Despite being potentially lifesaving, bowel obstruction surgery is associated with a high rate of death during surgery or shortly after the procedure. […] If left untreated, bowel obstruction can be life threatening. Emergency surgery may be needed to fix whatever is causing the blockage. […] People who require emergency bowel obstruction surgery tend to have a relatively high chance of death or complications either during surgery or shortly after. […] About 5% to 30% of people with small intestinal obstruction die within 30 days, according to a 2022 study. The rate is between 10% and 20% for large bowel obstruction. […] In a 2016 study, researchers found that the 30-day and 90-day mortality rates for 323 people undergoing emergency laparotomy for small bowel obstruction were 13% and 17%, respectively.
#20 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Despite being potentially lifesaving, bowel obstruction surgery is associated with a high rate of death during surgery or shortly after the procedure. […] If left untreated, bowel obstruction can be life threatening. Emergency surgery may be needed to fix whatever is causing the blockage. […] People who require emergency bowel obstruction surgery tend to have a relatively high chance of death or complications either during surgery or shortly after. […] About 5% to 30% of people with small intestinal obstruction die within 30 days, according to a 2022 study. The rate is between 10% and 20% for large bowel obstruction. […] In a 2016 study, researchers found that the 30-day and 90-day mortality rates for 323 people undergoing emergency laparotomy for small bowel obstruction were 13% and 17%, respectively.
#21 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Researchers also found that 28% of people had major complications within 30 days. […] The chances of dying after receiving bowel obstruction surgery seem to be lower among younger people. […] In a 2022 study, researchers examined the survival rate of people 40 to 74 years old and people over the age of 75 years who were treated for bowel obstruction between 2009 and 2019. […] Researchers found that people in the younger group had an in-hospital death rate of 8.9% compared with 18.2% for people in the older group. […] In the 2016 study mentioned above, researchers found that each 10-year increase in age was associated with a 30% higher chance of dying within 30 days of surgery. […] In a 2021 study, researchers found that the death rate of bowel obstruction surgery was significantly higher in women than men over the age of 65 years. The mortality rate was 10.6% in women and 2.6% in men.
#22 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Researchers also found that 28% of people had major complications within 30 days. […] The chances of dying after receiving bowel obstruction surgery seem to be lower among younger people. […] In a 2022 study, researchers examined the survival rate of people 40 to 74 years old and people over the age of 75 years who were treated for bowel obstruction between 2009 and 2019. […] Researchers found that people in the younger group had an in-hospital death rate of 8.9% compared with 18.2% for people in the older group. […] In the 2016 study mentioned above, researchers found that each 10-year increase in age was associated with a 30% higher chance of dying within 30 days of surgery. […] In a 2021 study, researchers found that the death rate of bowel obstruction surgery was significantly higher in women than men over the age of 65 years. The mortality rate was 10.6% in women and 2.6% in men.
#23 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Researchers also found that 28% of people had major complications within 30 days. […] The chances of dying after receiving bowel obstruction surgery seem to be lower among younger people. […] In a 2022 study, researchers examined the survival rate of people 40 to 74 years old and people over the age of 75 years who were treated for bowel obstruction between 2009 and 2019. […] Researchers found that people in the younger group had an in-hospital death rate of 8.9% compared with 18.2% for people in the older group. […] In the 2016 study mentioned above, researchers found that each 10-year increase in age was associated with a 30% higher chance of dying within 30 days of surgery. […] In a 2021 study, researchers found that the death rate of bowel obstruction surgery was significantly higher in women than men over the age of 65 years. The mortality rate was 10.6% in women and 2.6% in men.
#24 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Researchers also found that 28% of people had major complications within 30 days. […] The chances of dying after receiving bowel obstruction surgery seem to be lower among younger people. […] In a 2022 study, researchers examined the survival rate of people 40 to 74 years old and people over the age of 75 years who were treated for bowel obstruction between 2009 and 2019. […] Researchers found that people in the younger group had an in-hospital death rate of 8.9% compared with 18.2% for people in the older group. […] In the 2016 study mentioned above, researchers found that each 10-year increase in age was associated with a 30% higher chance of dying within 30 days of surgery. […] In a 2021 study, researchers found that the death rate of bowel obstruction surgery was significantly higher in women than men over the age of 65 years. The mortality rate was 10.6% in women and 2.6% in men.
#25 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Researchers also found that 28% of people had major complications within 30 days. […] The chances of dying after receiving bowel obstruction surgery seem to be lower among younger people. […] In a 2022 study, researchers examined the survival rate of people 40 to 74 years old and people over the age of 75 years who were treated for bowel obstruction between 2009 and 2019. […] Researchers found that people in the younger group had an in-hospital death rate of 8.9% compared with 18.2% for people in the older group. […] In the 2016 study mentioned above, researchers found that each 10-year increase in age was associated with a 30% higher chance of dying within 30 days of surgery. […] In a 2021 study, researchers found that the death rate of bowel obstruction surgery was significantly higher in women than men over the age of 65 years. The mortality rate was 10.6% in women and 2.6% in men.
#26 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Besides age, one of the most important factors for determining the chances of surviving bowel obstruction surgery is how quickly treatment is begun. […] The overall death rate was 7.2% within 30 days. Surgery delayed more than 72 hours was associated with a 39% higher chance of dying within 30 days. […] Factors associated with the highest chance of death were: poor physical performance, metabolic disease, obstructive pulmonary disease, needing a blood transfusion during surgery. […] Bowel obstruction surgery is associated with high rates of complications and death.
#27 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Besides age, one of the most important factors for determining the chances of surviving bowel obstruction surgery is how quickly treatment is begun. […] The overall death rate was 7.2% within 30 days. Surgery delayed more than 72 hours was associated with a 39% higher chance of dying within 30 days. […] Factors associated with the highest chance of death were: poor physical performance, metabolic disease, obstructive pulmonary disease, needing a blood transfusion during surgery. […] Bowel obstruction surgery is associated with high rates of complications and death.
#28 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Besides age, one of the most important factors for determining the chances of surviving bowel obstruction surgery is how quickly treatment is begun. […] The overall death rate was 7.2% within 30 days. Surgery delayed more than 72 hours was associated with a 39% higher chance of dying within 30 days. […] Factors associated with the highest chance of death were: poor physical performance, metabolic disease, obstructive pulmonary disease, needing a blood transfusion during surgery. […] Bowel obstruction surgery is associated with high rates of complications and death.
#29 Bowel Obstruction Surgery Survival Rates by Age, Other Factors
https://www.healthline.com/health/bowel-obstruction-surgery-survival-rates
Besides age, one of the most important factors for determining the chances of surviving bowel obstruction surgery is how quickly treatment is begun. […] The overall death rate was 7.2% within 30 days. Surgery delayed more than 72 hours was associated with a 39% higher chance of dying within 30 days. […] Factors associated with the highest chance of death were: poor physical performance, metabolic disease, obstructive pulmonary disease, needing a blood transfusion during surgery. […] Bowel obstruction surgery is associated with high rates of complications and death.
#30 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study | Scientific Reports
https://www.nature.com/articles/s41598-025-96593-4
The results of DCA analysis indicated that the model was reliable and could effectively predict the 30 – day, 90 – day, and 180 – day survival periods of MBO patients. […] This model identified multiple key prognostic factors and exhibited good predictive performance. […] It provides important reference for clinicians to predict the survival period of MBO patients and develop personalized treatment plans, and is expected to improve the clinical outcomes of MBO patients. […] Therefore, accurately assessing the prognosis of patients with malignant bowel obstruction is crucial for formulating reasonable treatment plans, improving the quality of life of patients, and prolonging their survival time. […] The model established in this study is of great significance. […] According to the model validation results, all C – index and AUC values are greater than or close to 0.9, indicating that the model has excellent predictability and accuracy. […] This means that the model can predict the survival of patients relatively stably on different data sets and provide a reliable basis for clinical decision – making.
#31 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study – PubMed
https://pubmed.ncbi.nlm.nih.gov/40185941/
The results of DCA analysis indicated that the model was reliable and could effectively predict the 30-day, 90-day, and 180-day survival periods of MBO patients. […] This study successfully constructed and validated a prognostic model for the overall survival of MBO patients. […] It provides important reference for clinicians to predict the survival period of MBO patients and develop personalized treatment plans, and is expected to improve the clinical outcomes of MBO patients.
#32 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study | Scientific Reports
https://www.nature.com/articles/s41598-025-96593-4
The results of DCA analysis indicated that the model was reliable and could effectively predict the 30 – day, 90 – day, and 180 – day survival periods of MBO patients. […] This model identified multiple key prognostic factors and exhibited good predictive performance. […] It provides important reference for clinicians to predict the survival period of MBO patients and develop personalized treatment plans, and is expected to improve the clinical outcomes of MBO patients. […] Therefore, accurately assessing the prognosis of patients with malignant bowel obstruction is crucial for formulating reasonable treatment plans, improving the quality of life of patients, and prolonging their survival time. […] The model established in this study is of great significance. […] According to the model validation results, all C – index and AUC values are greater than or close to 0.9, indicating that the model has excellent predictability and accuracy. […] This means that the model can predict the survival of patients relatively stably on different data sets and provide a reliable basis for clinical decision – making.
#33 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study – PubMed
https://pubmed.ncbi.nlm.nih.gov/40185941/
Malignant bowel obstruction (MBO) is a common and complex condition in clinical practice, which seriously affects the quality of life and prognosis of patients. […] However, the current lack of effective prognostic models for MBO has greatly limited clinical precision treatment and patient management. […] This study aims to construct and validate a prognostic model for the overall survival (OS) of MBO patients, providing crucial support for clinical decision-making and improving the prognosis of patients. […] The study found that significant risk factors affecting patient mortality included chemoradiotherapy ( = – 1.24; HR = 0.29;95%CI, 0.14-0.59), conservative treatment ( = 1.34; HR = 3.81; 95%CI, 1.69-8.55), new cases ( = – 0.96; HR = 0.38; 95%CI, 0.19-0.77), AJCC T stage 4 ( = 2.16; HR = 8.64; 95%CI, 1.47-50.76), red blood cell count (RBC, = – 0.63; HR = 0.53; ; 95%CI, 0.38-0.80), prothrombin time (PT, = 0.37; HR = 1.45; ; 95%CI, 1.07-1.97), aspartate aminotransferase (AST, = 0.01; HR = 1.01; 95%CI, 1.00-1.02), and intestinal necrosis ( = 1.73; HR = 5.62; 95%CI, 1.11-28.27).
#34 Development and validation of a clinical prognosis prediction model for malignant intestinal obstruction: A retrospective cohort study | Scientific Reports
https://www.nature.com/articles/s41598-025-96593-4
Malignant bowel obstruction (MBO) is a common and complex condition in clinical practice, which seriously affects the quality of life and prognosis of patients. […] However, the current lack of effective prognostic models for MBO has greatly limited clinical precision treatment and patient management. […] This study successfully constructed and validated a prognostic model for the overall survival of MBO patients. […] The study found that significant risk factors affecting patient mortality included chemoradiotherapy, conservative treatment, new cases, AJCC T stage 4, red blood cell count, prothrombin time, aspartate aminotransferase, and intestinal necrosis. […] In the development set, the AUC and C – index values of the prognostic models for 30 – day, 90 – day, and 180 – day are 0.87, 0.94, and 0.92 respectively.
#35 Development and validation of a nomogram model to predict the risk of strangulated intestinal obstruction | Scientific Reports
https://www.nature.com/articles/s41598-024-82131-1
To develop and validate a nomogram model for discriminating simple intestinal obstruction and strangulated intestinal obstruction, thus providing objective evidence for clinical decision-making. […] The mortality rate associated with StIO can reach 20-30%. Notably, in cases of bowel transmural necrosis, this mortality rate dramatically increases to 50%. […] Therefore, prompt surgical intervention is crucial in StIO to alleviate the obstruction, restore intestinal blood flow, and prevent necrosis and perforation. […] Delays in surgical intervention can further worsen mortality rates by 20-40%. Therefore, early and accurate identification of StIO, followed by prompt surgical intervention to relieve the obstruction, is critical for improving patient outcomes. […] This study developed and visualized an effective clinical risk prediction model for StIO based on NEUT%, ALB, peritoneal irritation signs, and the presence of abdominal fluid. The nomogram exhibited good discrimination, calibration, and clinical usefulness, facilitating the early prediction and identification of patients at high risk of StIO.
#36 Development and validation of a nomogram model to predict the risk of strangulated intestinal obstruction | Scientific Reports
https://www.nature.com/articles/s41598-024-82131-1
To develop and validate a nomogram model for discriminating simple intestinal obstruction and strangulated intestinal obstruction, thus providing objective evidence for clinical decision-making. […] The mortality rate associated with StIO can reach 20-30%. Notably, in cases of bowel transmural necrosis, this mortality rate dramatically increases to 50%. […] Therefore, prompt surgical intervention is crucial in StIO to alleviate the obstruction, restore intestinal blood flow, and prevent necrosis and perforation. […] Delays in surgical intervention can further worsen mortality rates by 20-40%. Therefore, early and accurate identification of StIO, followed by prompt surgical intervention to relieve the obstruction, is critical for improving patient outcomes. […] This study developed and visualized an effective clinical risk prediction model for StIO based on NEUT%, ALB, peritoneal irritation signs, and the presence of abdominal fluid. The nomogram exhibited good discrimination, calibration, and clinical usefulness, facilitating the early prediction and identification of patients at high risk of StIO.