Table 3 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 24 h of outcome
From: Surgical mortality in patients in extremis: futility in emergency abdominal surgery
N (%) | Dead at 24 h | Alive at 24 h | P-value | |
|---|---|---|---|---|
n = 25 (%) | n = 25 (%) | |||
Age (median) (IQR) years | 82.5 (18.25) | 74 (19.50) | 83 (15.50) | 0.236* |
Sex | ||||
Female | 17 (34.00) | 7 (28.00) | 10 (40.00) | 0.551 |
Male | 33 (66.00) | 18 (72.00) | 15 (60.00) | |
Body Mass Index (median) (IQR) kg/m2 | 25.00 (9.47) | 24.90 (9.4) | 26.00 (10.6) | 0.479* |
Comorbidities | ||||
Diabetes mellitus | 11 (22.00) | 5 (20.00) | 6 (24.00) | 1 |
Arterial hypertension | 41 (82.00) | 16 (64.00) | 25 (100.00) | 0.002 |
Chronic obstructive pulmonary disease O2 requirement | 17 (34.00) | 8 (32.00) | 9 (36.00) | 1 |
Non-O2 requirement obstructive pulmonary disease | 4 (8.00) | 2 (8.00) | 2 (8.00) | 1 |
Chronic kidney disease stage 5 | 9 (18.00) | 4 (16.00) | 5 (20.00) | 1 |
Heart failure | 15 (30.00) | 7 (28.00) | 8 (32.00) | 1 |
Acute myocardial infarction < 6 months | 2 (4.00) | 1 (4.00) | 1 (4.00) | 0.755 |
Oncologic disease | 12 (24.00) | 2 (8.00) | 10 (40.00) | 0.018 |
Terminal oncologic disease | 7 (14.00) | 0 (0.00) | 7 (28.00) | 0.01 |
Stroke with sequelae | 5 (10.00) | 2 (8.00) | 3 (12.00) | 1 |
Charlson Comorbidity Index (median) (IQR) points | 6 (2.25) | 6 (3.00) | 6 (2.50) | 0.630* |
Barthel Index (median) (IQR) points | 65 (31.25) | 65 (30.0) | 60 (32.5) | 0.102 |
Fragility Index (median) (IQR) points | 4.5 (3.00) | 4 (3.00) | 5 (2.00) | 0.232 |
Vasopressor | ||||
No | 15 (30.00) | 3 (12.00) | 12 (48.00) | 0.012 |
Yes | 35 (70.00) | 22 (88.00) | 13 (52.00) | |
Mechanical ventilation | ||||
No | 23 (46.00) | 7 (28.00) | 16 (64.00) | 0.022 |
Yes | 27 (54.00) | 18 (72.00) | 9 (36.00) | |
Glasgow (median) (IQR) points | 9 (7.00) | 6 (6.00) | 12 (7.50) | 0.019* |
APACHE II (median) (IQR) mortality | 36 (15.5) | 31.5(12.00) | 22 (15.75) | 0.078* |
SOFA (median) (IQR) points | 10 (7.00) | 13 (5.00) | 8 (6.00) | 0.002* |
Celiotomy (median) (IQR) points | 10 (7.50) | 13 (7.75) | 8 (5.00) | 0.007* |
Laboratories (median) (IQR) | ||||
Leukocytes (× 103) | 13.45 (10.65) | 13.56 (15.08) | 13.36 (9.05) | 0.522* |
Hemoglobin (mg/dl) | 11.1 (4.22) | 10.6 (3.9) | 11.4 (5.45) | 0.628* |
Platelets (× 103) | 170 (184.5) | 146 (145) | 206 (210) | 0.151* |
Creatinine (mg/dl) | 2.01 (2.23) | 2.78 (2.62) | 1.76 (1.58) | 0.138* |
Sodium (mEq/L) | 140 (6.5) | 140 (8.5) | 140 (6.0) | 0.593* |
Potassium (mEq/L) | 4.71 (1.34) | 4.8 (1.81) | 4.69 (1.61) | 0.248* |
Glycaemia (mg/dl) | 144 (94) | 124 (84.5) | 189 (98.5) | 0.133* |
Lactate (mol/L) | 5.4 (5.9) | 6.55 (6.55) | 3.4 (4.12) | 0.013* |
HCO3 | 16 (8.4) | 14.15 (7.55) | 17.8 (8.1) | 0.022* |
pH | 7.30 (0.26) | 7.20 (0.34) | 7.37 (0.19) | 0.007* |
Pa/FiO2 | 178 (99.5) | 162.5 (111.25) | 205 (162.5) | 0.011* |
Intraoperative findings | 4 (8.00) | 1 (4.00) | 3 (12.00) | 0.609 |
No finding | 5 (10.00) | 5 (20.00) | 0 (0.00) | 0.05 |
Overall Ischemia | 16 (32.00) | 11 (44.00) | 5 (20.00) | 0.128 |
Ischemia of an isolated segment | ||||
Colitis | 3 (6.00) | 0 (0.00) | 3 (12.00) | 0.235 |
GI Bleeding | 9 (18.00) | 4 (16.00) | 5 (20.00) | 1 |
Peptic ulcer | 4 (8.00) | 2 (8.00) | 2 (8.00) | 1 |
Peritonitis | 18 (36.00) | 8 (32.00) | 10 (40.00) | 0.769 |
Intestinal obstruction | 4 (8.00) | 1 (4.00) | 3 (12.00) | 0.609 |