Table 1 Comparison of demographic, clinical, and surgical characteristics of patients undergoing emergency laparotomy with a mortality risk greater than 75% according to the ACS -NSQIP Surgical Risk Calculator during the first at 30 days of outcome
From: Surgical mortality in patients in extremis: futility in emergency abdominal surgery
N (%) | Dead at 30 days n = 46 (%) | Alive at 30 days n = 4 (%) | P-value | |
|---|---|---|---|---|
Age (median) (IQR) years | 82.5 (18.25) | 82.5 (18.50) | 84 (10.25) | 0.19* |
Sex | ||||
Female | 17 (34.00) | 15 (32.61) | 2 (50.00) | 0.48 |
Male | 33 (66.00) | 31 (67.39) | 2 (50.00) | |
Body Mass Index (median) (IQR) kg/m2 | 25 (9.47) | 25.55 (8.02) | 16.75 (9.6) | 0.01* |
Comorbidities | ||||
Diabetes mellitus | 11 (22.00) | 10 (21.74) | 1 (25.00) | 0.64 |
Arterial hypertension | 41 (82.00) | 37 (80.43) | 4 (100.00) | 0.44 |
Chronic obstructive pulmonary disease with O2 requirement | 17 (34.00) | 17 (36.96) | 0 (0.00) | 0.17 |
Non-O2 requirement obstructive pulmonary disease | 4 (8.00) | 2 (4.35) | 2 (50.00) | 0.02 |
Chronic kidney disease stage 5 | 9 (18.00) | 8 (17.39) | 1 (25.00) | 0.17 |
Heart failure | 15 (30.00) | 13 (28.26) | 2 (50.00) | 0.34 |
Acute myocardial infarction < 6 months | 2 (4.00) | 2 (4.35) | 0 (0.00) | 0.84 |
Oncologic disease | 12 (24.00) | 10 (21.74) | 2 (50.00) | 0.24 |
Terminal oncologic disease | 7 (14.00) | 6 (13.04) | 1 (25.00) | 0.46 |
Stroke with sequelae | 5 (10.00) | 5 (10.87) | 0 (0.00) | 0.64 |
Charlson Comorbidity Index (median) (IQR) points | 6 (2.25) | 6 (2) | 4.5 (4.75) | 0.46 |
Barthel Index (median) (IQR) points | 65 (31.25) | 65 (30) | 42.5 (42.5) | 0.01* |
Fragility Index (median) (IQR) points | 4.5 (3.00) | 4 (3.00) | 5.5 (1.75) | 0.04* |
Vasopressor | ||||
No | 15 (30.00) | 11 (23.91) | 4 (100.00) | 0.00* |
Yes | 35 (70.00) | 35 (76.09) | 0 (0.00) | |
Mechanical ventilation | ||||
No | 23 (46.00) | 19 (41.30) | 4 (100.00) | 0.03* |
Yes | 27 (54.00) | 27 (58.70) | 0 (0.00) | |
Glasgow (median) (IQR) points | 9 (7.00) | 8 (7.00) | 13.5 (1.75) | 0.01* |
APACHE II (median) (IQR) mortality | 36 (15.5) | 31.5 (14.5) | 14.5 (9.25) | 0.00* |
SOFA (median) (IQR) points | 10 (7.00) | 11 (7.00) | 6 (2.75) | 0.02* |
Celiotomy (median) (IQR) points | 10 (7.50) | 10 (8.50) | 10.5 (3.25) | 0.40 |
Laboratories (median) (IQR) | ||||
Leukocytes (× 103) | 13.45 (10.65) | 13.45 (10.87) | 13.37 (12.41) | 0.37* |
Hemoglobin (mg/dl) | 11.1 (4.22) | 11.10 (4.15) | 12.3 (7.3) | 0.46* |
Platelets (× 103) | 170 (184.5) | 158 (170) | 300 (443) | 0.08* |
Creatinine (mg/dl) | 2.01 (2.23) | 2.04 (2.22) | 1.71 (6.44) | 0.39* |
Sodium (mEq/L) | 140 (6.5) | 140 (6.75) | 137 (10.5) | 0.04* |
Potassium (mEq/L) | 4.71 (1.34) | 4.70 (1.25) | 5.69 (1.75) | 0.06* |
Glycaemia (mg/dl) | 144 (94) | 138 (91.5) | 206 (165.5) | 0.02* |
Lactate (mol/L) | 5.4 (5.9) | 4.5 (6.59) | 5.85 (1.85) | 0.23* |
HCO3 | 16 (8.4) | 16 (8.75) | 15.5 (5.42) | 0.34* |
pH | 7.30 (0.26) | 7.30 (0.28) | 7.39 (0.11) | 0.09* |
Pa/FiO2 | 178 (99.5) | 175 (97.00) | 309.50 (129.75) | 0.00* |
Intraoperative findings | ||||
No finding | 4 (8.00) | 2 (4.35) | 2 (50.00) | 0.02 |
Overall ischemia | 5 (10.00) | 5 (10.87) | 0 (0.00) | 0.64 |
Ischemia of an isolated segment | 16 (32.00) | 14 (30.43) | 2 (50.00) | 0.38 |
Colitis | 3 (6.00) | 3 (6.52) | 0 (0.00) | 0.77 |
GI Bleeding | 9 (18.00) | 9 (19.57) | 0 (0.00) | 0.44 |
Peptic ulcer | 4 (8.00) | 4 (8.70) | 0 (0.00) | 0.70 |
Peritonitis | 18 (36.00) | 18 (39.13) | 0 (0.00) | 0.15 |
Intestinal obstruction | 4 (8.00) | 4 (8.7) | 0 (0.00) | 0.70 |