Three hundred patients with large bowel obstruction were treated by emergency operation in a county, Veterans Administration, and community hospital population. Primary carcinoma of the colon, volvulus, and diverticulitis were the etiological factors in 84% of the patients. The combined hospital mortality of 37% was distributed as follows: county, 42%; VA, 40%; and community, 30%. Mortality from obstructing carcinoma was similar in all institutions. This was apparently related to the frequent insidious onset. In contrast, the community hospital had a decided edge in the successful management of volvulus and obstructing diverticulitis. The more dramatic onset of these two diseases prompted the private patient to seek medical consultation earlier.
Greenlee HB, Pienkos EJ, Vanderbilt PC, et al. Acute Large Bowel Obstruction: Comparison of County, Veterans Administration, and Community Hospital Populations. Arch Surg. 1974;108(4):470–476. doi:10.1001/archsurg.1974.01350280076013
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