FP7.7 - Evaluation of small bowel obstruction management: A local audit in comparison to NASBO guidelines

Abstract Aims The National Audit of Small Bowel Obstruction (NASBO) report provides recommendations for optimising the management of small bowel obstruction (SBO). We aimed to audit our management and compare our outcomes with the NASBO report. Methods Retrospective case reviews were conducted for 115 patients admitted with SBO from July-December 2022, evaluating adherence to NASBO guidelines and assessing outcomes. Results The average age was 76 (21-94) years old; 53% male and 47% female. Adhesions (41.7%), hernias (30.4%), malignancy (13%) and inflammatory bowel disease (6.1%) were predominant causes. Treatment included conservative management in 67% of cases, surgery in 27% (of which, 6.1% had a trial of conservative management initially) and palliative care in 6.1%. A summary of the management and outcomes below.Table 1:Summary of managementCT scan on admissionAverage time to CTSurgery performedAverage time to surgeryNutritional screening assessmentLocal audit98.3%9 hours27%2.4 days100%NASBO80%2.2 days48%1 day90%Table 2:Summary of outcomesUnable to eat normally for ≥5 daysAverage length of stay30-day mortality30-day readmissionLocal audit12%7 days14%18%NASBO49%10.7 days8%13% Conclusion We are performing CT scans in a timely manner and screening for malnutrition. Despite a shorter length of stay compared to NASBO, our audit has identified opportunities to improve hospital readmission, suggesting that we may be discharging patients prematurely. We have introduced a SBO checklist to ensure NASBO recommendations are adhered to and to improve our 30-day outcomes.