Predictors of Morbidity and Mortality After Surgery for Intestinal Perforation

신루미; 이상목; 손병훈; 이동운; 송인호; 채영준; 이해원; 안혜성; 정인목; 정정기; 허승철

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자료유형: 학술저널

저자정보: 신루미 (보라매병원) 이상목 (보라매병원) 손병훈 (보라매병원) 이동운 (서울대학교) 송인호 (서울대학교병원) 채영준 (보라매병원) 이해원 (보라매병원) 안혜성 (보라매병원) 정인목 (보라매병원) 정정기 (보라매병원) 허승철 (보라매병원 외과)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.32 No.6

발행연도: 2016.1

수록면: 221 - 227 (7page)

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Purpose: An intestinal perforation is a rare condition, but has a high mortality rate, even after immediate surgical intervention. The clinical predictors of postoperative morbidity and mortality are still not well established, so this study attempted to identify risk factors for postoperative morbidity and mortality after surgery for an intestinal perforation. Methods: We retrospectively analyzed the cases of 117 patients who underwent surgery for an intestinal perforation at a single institution in Korea from November 2008 to June 2014. Factors related with postoperative mortality at 1 month and other postoperative complications were investigated. Results: The mean age of enrolled patients was 66.0 ± 15.8 years and 66% of the patients were male. Fifteen patients (13%) died within 1 month after surgical treatment. Univariate analysis indicated that patient-related factors associated with mortality were low systolic and diastolic blood pressure, low serum albumin, low serum protein, low total cholesterol, and high blood urea nitrogen; the surgery-related factor associated with mortality was feculent ascites. Multivariate analysis using a logistic regression indicated that low systolic blood pressure and feculent ascites independently increased the risk for mortality; postoperative complications were more likely in both females and those with low estimated glomerular filtration rates and elevated serum C-reactive protein levels. Conclusion: Various factors were associated with postoperative clinical outcomes of patients with an intestinal perforation. Morbidity and mortality following an intestinal perforation were greater in patients with unstable initial vital signs, poor nutritional status, and feculent ascites.

참고문헌 (36)

참고문헌 신청

Bielecki K / 2002 / Large bowel perforation: morbidity and mortality / Tech Coloproctol 6:177~182

Kriwanek S / 1994 / Prognostic factors for survival in colonic perforation / Int J Colorectal Dis 9:158~162

Pisanu A / 2004 / Surgical treatment of perforated diverticular disease: evaluation of factors predicting prognosis in the elderly / Int Surg 89:35~38

Ohmann C / 1993 / Prospective evaluation of prognostic scoring systems in peritonitis. Peritonitis Study Group / Eur J Surg 159:267~274

Kriwanek S / 1996 / Perforated colorectal cancer / Dis Colon Rectum 39:1409~1414

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