Risk Factors Associated with Intestinal Strangulation in Patients with Adhesive Small Bowel Obstruction: A Retrospective Analysis of 951 Cases.

OBJECTIVE:  To investigate the risk factors for intestinal strangulation in patients with adhesive small bowel obstruction (ASBO).  METHODS: A retrospective analysis was performed using the databases of the Department of Gastrointestinal Surgery, the First Hospital of Jilin University, and the Department of General Surgery, Rizhao People’s Hospital. A total of 951 patients diagnosed with ASBO between July 2015 and April 2023 were enrolled. Univariate and multivariate logistic regression models were applied to identify the risk factors for intestinal strangulation. RESULTS: Multivariate logistic regression analysis revealed that elevated heart rate, increased white blood cell (WBC) count, decreased intestinal wall density on computed tomography (CT), mesenteric edema (thickening) on CT, abdominal effusion, peritonitis, and persistent abdominal pain were independent risk factors for intestinal strangulation. The logistic regression model had a sensitivity of 95.40% and a specificity of 71.07%.  CONCLUSION: Elevated heart rate, increased WBC count, decreased intestinal wall density on CT, mesenteric edema (thickening) on CT, abdominal effusion, peritonitis, and persistent abdominal pain are independent risk factors for intestinal strangulation in ASBO patients, which can serve as important references for clinical diagnostic and therapeutic decision-making.