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23 August 2019 : Clinical Research  

Predictors of 30-Day In-Hospital Mortality in Patients Undergoing Urgent Abdominal Surgery Due to Acute Peritonitis Complicated with Sepsis

Asta Mačiulienė1ABDEF*, Almantas Maleckas2DEF, Algimantas Kriščiukaitis3CDE, Vytautas Mačiulis1BDEF, Justinas Vencius1DEF, Andrius Macas1ADE

DOI: 10.12659/MSM.915435

Med Sci Monit 2019; 25:6331-6340

Abstract

BACKGROUND: Sepsis is a life-threatening condition with high morbidity and mortality rate. Identifying early prediction factors of critical situations in intra-abdominal sepsis patients can help reduce mortality rates. This prospective study was carried out to evaluate the association of technically available factors with 30-day in-hospital mortality.

MATERIAL AND METHODS: There were 67 intra-abdominal sepsis patients included in the study; patients were observed for 30 days postoperatively. The data was processed using SPSS24.0 statistical analysis package. All tests that had a significance level of 0.05 were selected.

RESULTS: Septic shock in association with increase in age per year showed increase the odds of mortality and prognosed 30-days in hospital mortality correctly in 79% of cases. The observed OR was 12.24 (P<0.001). Multiple logistic regression model 2 for the 30-day mortality identified a combination of septic shock, age (≥70 years), time from peritonitis symptoms to surgery prognose mortality with accuracy of 82%. The most accurate model to prognose 30-day in-hospital mortality included the presents of septic shock, age, time from peritonitis symptoms to surgery, drop of MAP <65 mmHg) post-induction, the odds of mortality 8.86 (P=0.001). Severe hypotension post-induction was more frequent in patients who were not diagnosed with sepsis (P=0.035).

CONCLUSIONS: The present study revealed a simple indicator for the risk for death under diffuse peritonitis patients complicated with sepsis. Septic shock, increase in age per year, peritonitis symptoms lasting more than 30 hours, and severe hypotension post-induction had a negative prognostic value for mortality in patients with intra-abdominal sepsis, and might be a high risk for 30-day mortality.

Keywords: Mortality, peritonitis, Sepsis, Shock, Septic, Abdomen, Aged, Hospital Mortality, Lithuania, Middle Aged, Postoperative Complications, Prognosis, Prospective Studies, Risk Factors

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Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750