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Postoperative Gastrointestinal Impairment

Postoperative nausea and vomiting occurring within the first 24 hours of surgery are generally considered due to post-anesthetic effects. Gastrointestinal Impairment (GII) is characterized by vomiting, abdominal distention and pain > 24 hours postop.1 In most cases, this is the result of postoperative ileus (POI), generally occurring 2-7 days after surgery, with fewer than 6% of cases due to early postoperative bowel obstruction.2 GII may lead to dehydration, acute kidney injury and the need for readmission.

  1. Hrabe, J. et al. (October 2019).  Prospective Analysis of an Acoustic Biomarker for Successful Early Oral Re-Feeding after Major Abdominal Surgery [Abstract]. Abstract retrieved from https://journals.lww.com/journalacs/Citation/2019/10002/Prospective_Analysis_of_an_Acoustic_Biomarker_for.26.aspx
  2. Kim et al. Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A, 24(8), 543–549.

Up to 32%

of patients undergoing major abdominal
surgery will develop POI3

 

POI readmission rate is tied with surgical sight infection (SSI) as the number 1 cause of readmissions—up to 25%4

3. Vather, R., Trivedi, S. & Bissett, I. Defining Postoperative Ileus: Results of a Systematic Review and Global Survey. J Gastrointest Surg 17, 962–972 (2013).

4. Merkow, R. P., Ju, M. H., Chung, J. W., Hall, B. L., Cohen, M. E., Williams, M. V., Tsai, T. C., Ko, C. Y., & Bilimoria, K. Y. (2015). Underlying reasons associated with hospital readmission following surgery in the United States. JAMA: The Journal of the American Medical Association, 313(5), 483–495.

PrevisEA helps optimize postoperative care pathway decisions that are affected by postoperative ileus or other causes of GII such as:

  1. Can the patient successfully be re-fed on the day of surgery?
  2. When can the patient be safely discharged without concern for GII developing at home?
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