Low BMI as a predictor of duration of hospital stay among intestinal obstruction patients undergoing emergency laparotomy in Mulago Hospital

Abstract

BACKGROUND: Despite improved surgical techniques and efforts to ensure that surgery is safe for the patient, abdominal surgery is still associated with a certain risk of morbidity and mortality. This risk increases with the emergency status of the abdominal surgery. The rate of morbidity after abdominal surgery in Uganda was reported to be 10-28% and mortality was 10-20%. The nutritional status as determined by body mass index (BMI), as a predictor of duration of hospital stay, among patients with intestinal obstruction indicated for emergency surgery in Mulago is not known. This is an information gap that may affect the ability of the clinician to make a timely intervention to improve the nutritional status of a patient prior to surgery, and by so doing; the length of hospital stay may be affected. OBJECTIVE: The study sought to correlate the pre-operative BMI of patients undergoing emergency laparotomy to their individual duration of hospital stay. METHODS Design-This was a prospective cohort study carried out over a period of eight months (September -April 2012/13) on the surgical general wards and emergency ward. Patients aged 12 years and above with clinical diagnosis of intestinal obstruction indicated for emergency laparotomy were enrolled. Analysis: Data was entered into Epi-info and analyzed using STATA 11. Pearson χ² test and Fischer’s exact test were used to determine levels of association. Kaplan-Maier curves were used to demonstrate survival rate. RESULTS: 78 patients with intestinal obstruction were studied, 61.54% were male and 29.49% of the patients had a low BMI. The median duration of hospital stay was 8 (6-13) days. Low BMI was weakly associated to an increased length of hospital stay.