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    Home > Active Ingredient News > Digestive System Information > Gastroenterology Report: Predictors of mortality in patients with acute small bowel perforation transferred to the ICU after emergency surgery

    Gastroenterology Report: Predictors of mortality in patients with acute small bowel perforation transferred to the ICU after emergency surgery

    • Last Update: 2022-10-18
    • Source: Internet
    • Author: User
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    Gastrointestinal (GI) perforation is a common surgical emergency with high morbidity and mortality.
    Initially, patients often present with sudden abdominal pain, and in severe patients, symptoms of septic shock secondary to peritonitis can occur
    .
    Small bowel perforations are less common than perforations elsewhere throughout the gastrointestinal tract and often present with atypical clinical manifestations
    .
    However, small bowel perforations are more prone to serious and even life-threatening infections
    .
    Mechanical obstruction and immune-mediated disease (Crohn's disease) are the leading causes of small bowel perforation in Western countries, whereas small bowel perforation secondary to typhoid and tuberculosis is more common in developing countries
    .
    This study retrospectively analyzed ICU patients undergoing emergency surgery for small bowel perforation to investigate prognostic factors associated with postoperative mortality
    .

    The researchers retrospectively analyzed the clinical data of patients with small bowel perforation who were admitted to the ICU of Fudan University Zhongshan Hospital from February 2011 to May 2020
    .
    The patient's medical records were analyzed in detail to identify differences in clinical characteristics, laboratory parameters, surgical outcomes, and pathology
    .

    A total of 104 patients were included in this study, of whom 18 (17.
    3%) underwent perforation repair, 59 (56.
    7%) underwent segmental resection and primary anastomosis, and 27 (26.
    0%) underwent enterostomy
    .
    Malignancy was the main cause of perforation in these patients (40.
    4%, 42/104)
    .
    The overall postoperative morbidity and mortality were 74.
    0% (77/104) and 19.
    2% (20/104), respectively
    .
    Malignancy-related perforation (odds ratio [OR], 4.
    659; 95% confidence interval [CI], 1.
    269-17.
    105; P = 0.
    020) and high postoperative arterial lactate levels (OR, 1.
    479; 95% CI, 1.
    027-2.
    131; P=0.
    036) was identified as an independent risk factor for postoperative mortality in patients with small bowel perforation transferred to the ICU
    .

    This study confirms that patients with small bowel perforation who are transferred to the ICU after emergency surgery are at high risk for postoperative complications and death
    .
    In addition, patients with malignancy-related perforation and higher postoperative blood lactate levels had a poorer prognosis
    .

    Original source:

    Jianzhang Wu.
    et al.
    Predictors of mortality in patients with acute small-bowel perforation transferred to ICU after emergency surgery: a single-centre retrospective cohort study.
    Gastroenterology Report.
    2022.

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