Comprehensive Analysis of Baseline Risk Variables for Postoperative Ileus Development in Gastrointestinal Surgery Patients

Abstract

Background: Postoperative ileus (POI) is a common and significant complication following gastrointestinal surgery, affecting up to 12.5% of patients. It leads to prolonged hospital stays, patient discomfort, and an increased risk of postoperative complications. Despite numerous studies, identifying consistent risk factors for POI remains challenging due to varying definitions and study methodologies. This systematic review and meta-analysis aim to identify baseline risk factors associated with POI following gastrointestinal surgery.
Methods: A systematic review was conducted following PRISMA, MOOSE, and Cochrane Handbook guidelines. Literature from MEDLINE, EMBASE, and the Cochrane Library was searched up to May 2024 for studies evaluating preoperative risk factors for POI in adult gastrointestinal surgery patients. Data extraction and bias assessment were carried out using standardized methods. A meta-analysis was performed for risk factors reported in two or more studies, using random-effects models to calculate pooled odds ratios (OR).
Results: From an initial 2,500 articles, 28 studies were included in the qualitative analysis, . The studies collectively involved 57,767 patients, of whom 6,127 developed POI.
Conclusion: Male sex is a significant risk factor for postoperative ileus following gastrointestinal surgery, while prior abdominal surgery does not show a clear association. The findings highlight the need for standardized definitions of POI and further research to confirm the role of comorbid conditions in its development. Understanding these baseline risk factors is crucial for developing strategies to prevent and manage POI effectively.