| Prognostic factors and scoring system for survival in colonic perforation. | |
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MedLine Citation:
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PMID: 15966200 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/AIMS: No ideal and generally accepted prognostic factors and scoring systems exist to determine the prognosis of peritonitis associated with colonic perforation. This study was designed to investigate prognostic factors and evaluate the various scoring systems to allow identification of high-risk patients. METHODOLOGY: Between 1996 and 2003, excluding iatrogenic and trauma cases, 26 consecutive patients underwent emergency operations for colorectal perforation and were selected for this retrospective study. Several clinical factors were analyzed as possible predictive factors, and APACHE II, SOFA, MPI, and MOF scores were calculated. RESULTS: The overall mortality was 26.9%. Compared with the survivors, non-survivors were found more frequently in Hinchey's stage III-IV, a low preoperative marker of pH, base excess (BE), and a low postoperative marker of white blood cell count, PaO2/FiO2 ratio, and renal output (24h). According to the logistic regression model, BE was a significant independent variable. Concerning the prognostic scoring systems, an APACHE II score of 19, a SOFA score of 8, an MPI score of 30, and an MOF score of 7 or more were significantly related to poor prognosis. CONCLUSIONS: Preoperative BE and postoperative white blood cell count were reliable prognostic factors and early classification using prognostic scoring systems at specific points in the disease process are useful to improve our understanding of the problems involved. |
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Authors:
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Shuhei Komatsu; Takumi Shimomatsuya; Masayuki Nakajima; Hirokazu Amaya; Taketsune Kobuchi; Susumu Shiraishi; Sayuri Konishi; Susumu Ono; Kazuhiro Maruhashi |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Hepato-gastroenterology Volume: 52 ISSN: 0172-6390 ISO Abbreviation: Hepatogastroenterology Publication Date: 2005 May-Jun |
Date Detail:
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Created Date: 2005-06-21 Completed Date: 2005-12-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8007849 Medline TA: Hepatogastroenterology Country: Greece |
Other Details:
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Languages: eng Pagination: 761-4 Citation Subset: IM |
Affiliation:
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Department of Surgery, Nagahama Red Cross Hospital, Nagahama, Shiga, Japan. skomatsu@koto.kpu-m.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Aged Aged, 80 and over Cause of Death Colonic Diseases / mortality*, surgery Emergencies Female Hospital Mortality Humans Intestinal Perforation / mortality*, surgery Logistic Models Male Middle Aged Peritonitis / mortality*, surgery Postoperative Complications / mortality Prognosis Retrospective Studies Risk Factors Severity of Illness Index Survival Rate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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