Document Detail


Prognostic factors and scoring system for survival in colonic perforation.
MedLine Citation:
PMID:  15966200     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Shuhei Komatsu; Takumi Shimomatsuya; Masayuki Nakajima; Hirokazu Amaya; Taketsune Kobuchi; Susumu Shiraishi; Sayuri Konishi; Susumu Ono; Kazuhiro Maruhashi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  52     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2005 May-Jun
Date Detail:
Created Date:  2005-06-21     Completed Date:  2005-12-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  761-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, Nagahama Red Cross Hospital, Nagahama, Shiga, Japan. skomatsu@koto.kpu-m.ac.jp
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MeSH Terms
Descriptor/Qualifier:
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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