{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:51:57Z","timestamp":1777449117760,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2024,4,21]],"date-time":"2024-04-21T00:00:00Z","timestamp":1713657600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>Introduction: Small bowel obstruction (SBO) is a common cause of hospital admission leading to resource utilization. The majority of these patients require non-operative management (NOM) which can lead to increased length of stay (LOS), readmissions, resource utilization, and throughput delays. Early surgical consultation (SC) for SBO may improve efficiency and outcomes. Methods: We implemented an institution-wide intervention (INT) to encourage early SC (&lt;1\u00a0day of diagnosis) for SBO patients in July 2022. A retrospective analysis was performed on all patients with SBO requiring NOM from January 2021 to June 2023, categorized into pre- and post-INT groups. The primary outcome was the number of SC\u2019s and secondary outcomes were early SC (&lt;1\u00a0day of diagnosis), utilization of SBFT, LOS, 30-day readmission, and costs of admission. Results: A total of 670 patients were included, 438 in the pre-INT and 232 in the post-INT group. Overall, SBFT utilization was significantly higher in cases with SC (17.2% vs 41.4%, P &lt; .001). Post-INT patients were more likely to receive SC (94.0% vs 83.3%, P &lt; .001) and increased SBFT utilization (47.0% vs 33.6%, P = .001). Additionally, early SC improved significantly in the post-INT group (74.3% vs 65.7%, P = .03). There was no difference in LOS between groups (4.0 vs 3.8 days, P = .48). There was a trend toward decreased readmission rates in the INT group at 30\u00a0days (7.3% vs 11.0%, P = .13) and reduced direct costs in the INT group (US$\/admission = 8467 vs 8708, P = .1). Conclusion: Hospital-wide interventions to increase early surgical involvement proved effective by improving early SC, increased SBFT utilization, and showed a trend towards decreased readmission rates and direct costs.<\/jats:p>","DOI":"10.1177\/00031348241248797","type":"journal-article","created":{"date-parts":[[2024,4,21]],"date-time":"2024-04-21T21:57:40Z","timestamp":1713736660000},"page":"2442-2446","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Don\u2019t Let the Sun Rise on Small Bowel Obstruction Without Surgical Consultation\u2014Redefining Nonoperative Management Pathways"],"prefix":"10.1177","volume":"90","author":[{"given":"Umar F.","family":"Bhatti","sequence":"first","affiliation":[{"name":"Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aricia S.","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Melo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Galinos","family":"Barmparas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew S.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Margulies","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo F.","family":"Alban","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,4,21]]},"reference":[{"key":"bibr1-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2020.01.025"},{"key":"bibr2-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1016\/j.yasu.2005.05.001"},{"key":"bibr3-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01347.x"},{"key":"bibr4-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-021-06061-z"},{"key":"bibr5-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1177\/00031348221085669"},{"key":"bibr6-00031348241248797","first-page":"1969040","volume":"2022","author":"Paulson MR","year":"2022","journal-title":"Case Rep Gastrointest Med"},{"key":"bibr7-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-021-00379-8"},{"key":"bibr8-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1111\/ans.16392"},{"key":"bibr9-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001861"},{"key":"bibr10-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2015.03.054"},{"issue":"5","key":"bibr11-00031348241248797","first-page":"e15023","volume":"13","author":"Ali M","year":"2021","journal-title":"Cureus"},{"key":"bibr12-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1177\/00031348211050823"},{"key":"bibr13-00031348241248797","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200207000-00002"},{"key":"bibr14-00031348241248797","unstructured":"Eastern Association for the Surgery of Trauma. Evaluation and Management of Small Bowel Obstruction. https:\/\/www.east.org\/education-resources\/practice-management-guidelines\/details\/smallbowel-obstruction-evaluation-and-management-of. published 2012."}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241248797","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348241248797","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241248797","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:40:05Z","timestamp":1777380005000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348241248797"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,21]]},"references-count":14,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1177\/00031348241248797"],"URL":"https:\/\/doi.org\/10.1177\/00031348241248797","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,21]]}}}