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Damage control surgery in non-traumatic abdominal emergencies: prognostic value of SOFA, APACHEII, and Mannheim peritonitis index.
Rasslan, Roberto; de Oliveira Ferreira, Fábio; Parra, Jeammy Andrea Perez; da Costa Ferreira Novo, Fernando; Menegozzo, Carlos Augusto Metidieri; Alves, Pedro Henrique Ferreira; Bertolli, Eduardo; Damous, Sérgio Henrique Bastos; Rasslan, Samir; Utiyama, Edivaldo Massazo.
Afiliação
  • Rasslan R; Departament of Surgery, Division of General Surgery and Trauma, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, no. 255, 8th. Floor, São Paulo, Brazil. robertorasslan@uol.com.br.
  • de Oliveira Ferreira F; Departament of Surgery, Division of General Surgery and Trauma, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, no. 255, 8th. Floor, São Paulo, Brazil.
  • Parra JAP; Departament of Surgery, Division of General Surgery and Trauma, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, no. 255, 8th. Floor, São Paulo, Brazil.
  • da Costa Ferreira Novo F; Departament of Surgery, Division of General Surgery and Trauma, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, no. 255, 8th. Floor, São Paulo, Brazil.
  • Menegozzo CAM; Departament of Surgery, Division of General Surgery and Trauma, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, no. 255, 8th. Floor, São Paulo, Brazil.
  • Alves PHF; Departament of Surgery, Division of General Surgery and Trauma, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, no. 255, 8th. Floor, São Paulo, Brazil.
  • Bertolli E; Departament of Surgery, Division of General Surgery and Trauma, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, no. 255, 8th. Floor, São Paulo, Brazil.
  • Damous SHB; Departament of Surgery, Division of General Surgery and Trauma, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, no. 255, 8th. Floor, São Paulo, Brazil.
  • Rasslan S; Departament of Surgery, Division of General Surgery and Trauma, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, no. 255, 8th. Floor, São Paulo, Brazil.
  • Utiyama EM; Departament of Surgery, Division of General Surgery and Trauma, Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, no. 255, 8th. Floor, São Paulo, Brazil.
Updates Surg ; 2024 Sep 13.
Article em En | MEDLINE | ID: mdl-39266908
ABSTRACT
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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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Updates Surg Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Itália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Updates Surg Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Itália