Factores determinantes de la supervivencia en pacientes con obstrucción intestinal maligna en cuidados paliativos.

Abstract

Malignant bowel obstruction (MBO) is a common complication in patients with advanced cancer, associated with high symptom burden and limited survival. This study aimed to identify clinical, demographic, and therapeutic factors associated with survival in patients with MBO treated in the palliative care unit at the National Oncology Institute SOLCA Guayaquil, from October 2020 to January 2025. An observational, retrospective, analytical study was conducted using data from 85 medical records. Median survival was 18 days. Lymphopenia and elevated urea levels were linked to poorer survival. Previous chemotherapy and restoration of bowel transit were significantly associated with longer survival, as was opioid use. Palliative surgery reduced the risk of mortality, while corticosteroid use was linked to higher risk. A body mass index in the overweight range and better functional status (measured by PPS) were also positively correlated with longer survival. These findings emphasize the relevance of comprehensive assessments that integrate clinical and functional variables to personalize therapeutic strategies in patients with MBO receiving palliative care.