Extra-abdominal CT imaging indicates increased severity of illness in advanced age patients requiring emergency abdominal surgery

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2025-06-01 Epub Date: 2025-03-12 DOI:10.1016/j.amjsurg.2025.116297

Lavina Malhotra , Andrew H. Stephen , Madeline Goosman , Adam R. Aluisio , Mohammed Arafeh , Charles A. Adams , Stephanie N. Leuckel , Brent Emigh , Benjamin M. Hall , Daithi S. Heffernan

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Abstract

Background

Abdominal sepsis frequently causes neurologic and pulmonary dysfunction among geriatric patients, We hypothesize that patients with abdominal sepsis who undergo extra-abdominal imaging have a greater burden of illness.

Methods

Patients 65 years and older that underwent emergency abdominal surgery for sepsis were divided into those with abdominal only(AbdCT) versus abdominal and extra-abdominal(ExtraCT) imaging.

Results

ExtraCT patients(N = 30) compared to AbdCT(N = 97) had higher rates of dementia(13.3 % versus 3.3 %; p = 0.03), diabetes(93.3 % versus 60.1 %; p < 0.01 and COPD(70 % versus 29.9 %; p < 0.01) but lower rates of abdominal pain as chief complaint (23.3 % versus 81.4 %; p < 0.01) and higher rates of being qSOFA positive (33.3 % vs 7.2 %; p < 0.05). Importantly, time to OR was not different between groups. ExtraCT patients had higher rates of 30-day mortality (33.3 % vs 5.2 %; p < 0.01). Extra-abdominal CT imaging was associated with increased risk of mortality (OR = 5.4; 95 %CI = 1.4–20.1).

Conclusions

ExtraCT among geriatric patients with abdominal emergencies is a marker of severity of illness and should guide end-of-life decision making.

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腹外CT成像显示需要紧急腹部手术的高龄患者病情严重程度增加。

背景：腹部败血症在老年患者中经常引起神经和肺功能障碍，我们假设腹部败血症患者接受腹外成像有更大的疾病负担。方法：65岁及以上因脓毒症接受紧急腹部手术的患者分为仅腹部（AbdCT）和腹部及腹外（ExtraCT）成像两组。结果：与AbdCT（N = 97）相比，ExtraCT患者（N = 30）的痴呆率更高(13.3% vs 3.3%；P = 0.03)，糖尿病(93.3% vs 60.1%；结论：老年急腹症患者的提取物是疾病严重程度的标志，应指导临终决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.