Clinical characteristics, treatment strategies, and outcomes of intestinal obstruction in geriatric patients: A comparative cohort study.

OBJECTIVE: Intestinal obstruction remains one of the most common surgical emergencies and is associated with considerable morbidity and mortality, particularly in elderly patients. Age-related physiological changes, multiple comorbidities, and delayed presentation may adversely affect treatment outcomes. This study aimed to compare the clinical characteristics, management strategies, and outcomes of geriatric patients with intestinal obstruction with those of younger adults. MATERIAL AND METHODS: This retrospective single-center cohort study included 277 adult patients hospitalized for mechanical intestinal obstruction between January 2018 and December 2025. Patients were divided into a geriatric group (≥65 years, n=171) and a younger group (<65 years, n=106). Demographic characteristics, comorbidities, laboratory findings, etiology of obstruction, treatment modalities, postoperative complications, intensive care unit (ICU) admission, and mortality were analyzed. Major complications were defined as Clavien-Dindo grade III or higher. Multivariable logistic regression analysis was performed to identify independent predictors of mortality. RESULTS: Geriatric patients had significantly higher rates of comorbidity (66.7% vs. 45.3%, p<0.001), delayed hospital presentation (59.1±53 vs. 35.4±24 hours, p<0.001), elevated C-reactive protein and creatinine levels, and lower glomerular filtration rates compared with younger patients. The distribution of obstruction etiologies differed significantly between groups (p<0.001). Although overall surgical treatment rates were similar (53.2% vs. 44.3%, p=0.14), geriatric patients required ICU admission more frequently (51.5% vs. 31.1%, p<0.001). Major complications occurred significantly more often in the geriatric group (31.0% vs. 7.5%, p<0.001). Mortality was markedly higher among elderly patients (14.0% vs. 0.9%, p<0.001). Multivariable logistic regression identified increasing age (odds ratio: 1.08, 95% confidence interval: 1.01-1.16, p=0.033) and surgical treatment (OR 4.92, 95% CI 1.44-16.83, p=0.011) as independent predictors of mortality. CONCLUSION: Geriatric patients with intestinal obstruction experience significantly higher morbidity and mortality than younger adults. Advanced age is an independent predictor of mortality, highlighting the importance of early diagnosis, careful perioperative assessment, and optimized management strategies in this high-risk population.