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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引用次数: 0
摘要
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。
Extra-abdominal CT imaging indicates increased severity of illness in advanced age patients requiring emergency abdominal surgery
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.
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.
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