Does osteopathic manipulative treatment (OMT) improves outcomes in patients who develop postoperative ileus: A retrospective chart review

Abstract 

Introduction

The treatment of ileus has been estimated to cost the United States $750 million to $1 billion in a year. In a study by Bennett-Guerrero et al. on 1056 patients who had major non-cardiac surgery, the most frequent problem that delayed discharge was persistent postoperative GI tract dysfunction in 42% of patients. Despite its huge cost to our society, there have been very few advances in our approach to treatment of ileus. Upon reviewing osteopathic literature for treatment of postoperative ileus it seemed that OMT may be of benefit to patients being treated for ileus in the hospital setting.

Materials and methods

All patients (n=655) with a discharge diagnosis of ileus (ICD-9-CM International Code 530.1) between 2003 and 2006 were reviewed. There where 331 patients who had undergone abdominal surgery and were included in the study. Patient records were then divided into two groups, those who had received osteopathic manipulative treatment (OMT) and those who had not received OMT. The data for this study was analyzed using ANCOVA.

Results

An analysis of covariance (ANCOVA) computed on length of stay by group with age as the covariate indicated that the OMT patients had a significantly shorter length of stay than the no treatment group (adjusted mean=14.6 days for the non-treatment group versus 11.8 days for the treatment group) even after controlling for age differences; F (1,308)=4.81, p=0.029.

Conclusion

The findings of this retrospective chart review indicate that a prospective trial including a more thorough economic cost-benefit analysis would be worthy of consideration.

Keywords: Osteopathic medicine, Manipulation, Ileus, Cost analysis, Outcomes, Cost effective