Perioperative clinical parameters associated with short-term mortality after colorectal perforation

Tadashi Matsuoka, Ryo Yamamoto, Kazuki Matsumura, Rie Kondo, Kenji Kobayashi, Alan Kawarai Lefor, Junichi Sasaki, Hiroharu Shinozaki

研究成果: Article査読

抄録

Purpose: Although early prediction of mortality is useful for the management of patients with colorectal perforations, no significant perioperative predictive factors have been identified. The purpose of this study was to identify useful prognostic factors for patients with colorectal perforation. Methods: This single-center retrospective study included consecutive patients undergoing emergency surgery for colorectal perforation from January 2012 to December 2019. The primary outcome was combined 30 day and in-hospital mortality. Patient- and disease-related factors obtained perioperatively were evaluated for mortality prediction. A scoring system was developed to enhance clinical utility. Results: Overall, 146 patients were included and 20 (14%) died after surgery. Multivariate logistic regression identified five predictive factors: age, hemodialysis, uncommon perforation etiology, plasma albumin level, and decreased platelet count. The area under the receiver operating curve for the scoring system using these parameters was 0.894 (95% CI 0.835–0.952). Patients at high-risk of mortality were classified by the proposed score with a sensitivity of 90.0% and negative predictive value of 98.0%. Conclusion: This study identified five perioperative factors significantly associated with mortality of patients with colorectal perforation. Although these parameters predict mortality of patients with colorectal perforation using a score with high discrimination, further study is required to confirm these findings.

本文言語English
ページ(範囲)3017-3024
ページ数8
ジャーナルEuropean Journal of Trauma and Emergency Surgery
48
4
DOI
出版ステータスPublished - 2022 8月

ASJC Scopus subject areas

  • 外科
  • 救急医学
  • 整形外科およびスポーツ医学
  • 集中医療医学

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