Damage control surgery in non-traumatic abdominal emergencies: prognostic value of SOFA, APACHEII, and Mannheim peritonitis index.

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Tác giả: Pedro Henrique Ferreira Alves, Eduardo Bertolli, Fernando da Costa Ferreira Novo, Sérgio Henrique Bastos Damous, Fábio de Oliveira Ferreira, Carlos Augusto Metidieri Menegozzo, Jeammy Andrea Perez Parra, Roberto Rasslan, Samir Rasslan, Edivaldo Massazo Utiyama

Ngôn ngữ: eng

Ký hiệu phân loại:

Thông tin xuất bản: Italy : Updates in surgery , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 735694

 This study aimed to analyze the prognostic value of the SOFA, APACHE II, and MPI (Mannheim Peritonitis Index) scores in the indication for Damage Control Surgery (DCS) in non-trauma. Retrospective analysis of patients undergoing DCS between 2014 and 2019. SOFA and APACHE II scores were calculated using parameters preceding DCS, while MPI was based on surgical descriptions. Statistical analysis: Qualitative variables were compared using the Chi-square test or Fisher's exact test, and quantitative variables using Pearson's correlation coefficient. The Student's T test was employed for mean comparisons. The sample comprised 104 patients (59 males), with a median age of 63.5 years, of whom 52 (50%) were ASA IV. Operative findings leading to DCS included peritonitis (54
  51.9%), intestinal ischemia (39
  37.5%), inability to close the abdomen (8
  7.6%), and bleeding (3
  2.9%). The mortality rate was 75% (78/104). Thirty patients (28.8%) died after DCS
  the remainder underwent one (35
  33.6%), two (21
  20.2%)
  three (8
  7.7%), and four or more (10
 9.7%) revision procedures. The median lengths of ICU and hospital stays were 12.5 and 20.5 days, respectively. The median score values were as follows: SOFA: 12 (0-38), APACHE II: 25 (2-47), and MPI: 26 (8-43). Besides ASA classification (p = 0.03), mortality risk was influenced by: age (≤ 65 years vs. >
  65 years
  p = 0.04), SOFA (≤ 10 vs. >
  10
  p = 0.03), APACHE II (≤ 25 vs. >
  25
  p = 0.04), and MPI (≤ 25 vs. >
  25
  p = 0.003). The SOFA, APACHE II, and MPI scores proved to be valuable tools in the prognostic assessment of patients undergoing DCS in non-traumatic abdominal emergencies.
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