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.²GII may lead to dehydration, acute kidney injury and the need for readmission.

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
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:

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