Effect of a clinical pathway in patients with Crohn's disease complicated with intestinal obstruction.
- Author:
Zhen GUO
;
Lei CAO
;
Jianfeng GONG
;
Yi LI
;
Lili GU
;
Weiming ZHU
1
;
Jieshou LI
Author Information
- Publication Type:Journal Article
- MeSH: Critical Pathways; Crohn Disease; complications; therapy; Female; Hospital Costs; statistics & numerical data; Humans; Intestinal Obstruction; complications; therapy; Intraoperative Complications; epidemiology; Length of Stay; statistics & numerical data; Male; Patient Readmission; statistics & numerical data; Postoperative Complications; epidemiology; Surgical Stomas; statistics & numerical data; Treatment Outcome
- From: Chinese Journal of Gastrointestinal Surgery 2017;20(1):53-57
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the effect of a clinical pathway for Crohn disease (CD) complicated with intestinal obstruction.
METHODSCD patients complicated with intestinal obstruction in Inflammatory Bowel Disease(IBD) Center of Jinling Hospital were enrolled. One hundred and nineteen CD patients from March 2014 to September 2015 received treatment with the clinical pathway (CP), which was developed based on medical evidence and experience of the IBD center in February 2014, as CP group. The other 108 CD patients from September 2012 to February 2014 received treatment according to the management strategy made by individual attending physician as non-CP group. Rate of operation, rate of stoma, morbidity of surgical complications, hospital stay, hospital cost, and 6-month unplanned re-admission were compared between two groups.
RESULTSThe baseline data were similar between the two group (all P > 0.05). No significant differences were noted between these the two groups in terms of rate of operation (73.9% vs. 77.8%, P = 0.605), rate of stoma (15.9% vs. 25.0%, P = 0.197), and morbidity of surgical complications (23.9% vs. 27.4%, P = 0.724). However, the mean postoperative hospital stay was shorter (10.9 d vs. 13.2 d, P = 0.000), the mean hospital cost was less (78 325 Yuan vs. 85 310 Yuan, P = 0.031) and the rate of 6-month unplanned re-admission was lower(3.4% vs. 11.1%, P = 0.035) in CP group.
CONCLUSIONTreatment based on this CP for CD patients complicated with intestinal obstruction can reduce the rate of 6-month unplanned re-admission, shorten the postoperative hospital stay and decrease the hospital cost in patients requiring surgery.
