Predictors of mortality in patients with acute smallbowel perforation transferred to ICU after emergency surgery:a single-centre retrospective cohort study  

作　　者：Jianzhang Wu Ping Shu Hongyong He Haojie Li Zhaoqing Tang Yihong Sun Fenglin Liu 

机构地区：[1]Department of General Surgery,Zhongshan Hospital,Fudan University,Shanghai,P.R.China

出　　处：《Gastroenterology Report》2022年第1期305-312,共8页胃肠病学报道（英文）

基　　金：supported by National Nature Science Foundation of China(No.82172803).

摘　　要：Background Although small-bowel perforation is a life-threatening emergency even after immediate surgical intervention,studies have rarely investigated surgical outcomes due to its relatively low incidence.This study aimed to investigate the outcomes of emergency surgery for patients with small-bowel perforation transferred to the intensive care unit(ICU)and the risk factors for mortality.Methods Consecutive patients with small-bowel perforation who were confirmed via emergency surgery and transferred to the ICU in Zhongshan Hospital,Fudan University(Shanghai,China)between February 2011 and May 2020 were retrospectively analysed.Medical records were reviewed to determine clinical features,laboratory indicators,surgical findings,and pathology.Results A total of 104 patients were included in this study,among whom 18(17.3%),59(56.7%),and 27(26.0%)underwent perforation repair,segmental resection with primary anastomosis,and small-bowel ostomy,respectively.Malignant tumours were the leading cause of perforation in these patients(40.4%,42/104).The overall post-operative complication rate and mortality rates were 74.0%(77/104)and 19.2%(20/104),respectively.Malignant tumour-related perforation(odds ratio[OR],4.659;95%confidence interval[CI],1.269–17.105;P=0.020)and high post-operative arterial blood-lactate level(OR,1.479;95%CI,1.027–2.131;P=0.036)were identified as independent risk factors for post-operative mortality in patients with small-bowel perforation transferred to the ICU.Conclusions Patients with small-bowel perforation who are transferred to the ICU after emergency surgery face a high risk of post-operative complications and mortality.Moreover,those patients with malignant tumour-related perforation and higher post-operative blood-lactate levels have poor prognosis.

关 键 词：small-bowel perforation blood lactate APACHE-II score malignant tumour 

分 类 号：R574[医药卫生—消化系统]