Objectives Malignant bowel obstruction (MBO) represents a devastating sequelae of gynecologic cancer. The Henry Score was developed to predict 30-day mortality and identify candidates for surgical management of MBO. The initial study only included 25% gynecologic patients, and this score has never been validated in a gynecologic cohort. Our objectives were to 1) assess survival and 2) evaluate predictive utility of the Henry Score for gynecologic patients.
Methods Retrospective review was performed on gynecologic cancer patients admitted with MBO to a single institution between 2016 and 2018.
Results A total of 80 MBO-related admissions were analyzed. 36.25% of patients underwent procedural intervention (surgery (6.25%), stenting (5.0%), or gastrostomy tube (21.3%)). Median length of stay was 5 days (Range 1–46). 30-day readmission rate was 40.0%. Mortality at 1, 3 and 6 months from first MBO admission was 20.4%, 46.3% and 64.8%, respectively. Median survival after first admission was 69.5 days (100 days in the surgical cohort (Range 65–208); 87 days in the non-surgical cohort (Range 1–248)). Mean Henry Score on admission was 2.5 (±1.06). When comparing ‘high’ Henry scores (4 to 5) vs.’low’ scores (0 to 1), high scores were associated with increased hospice admission (46.2% vs. 8.3%) and 30-day mortality (38.5% vs. 0%). Likelihood of procedural intervention and length of stay did not correlate with score.
Conclusions Gynecologic cancer patients with MBO have high rates of readmission and mortality. The Henry Score may have utility in this setting and inform counseling regarding outcomes. Further validation of the Henry Score in this population is warranted.
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