Mortality and Morbidity Prediction for Older Patients Undergoing Emergency Abdominal Surgery—Comparison of the POSSUM, E-PASS Score, and SASA Score

2020 ◽  
Vol 82 (4) ◽  
pp. 551-558
Author(s):  
Kenig Jakub ◽  
Mastalerz Kinga ◽  
Szabat Kinga ◽  
Skorus Urszula ◽  
Rapacz Kamil
Author(s):  
Chris Dodds ◽  
Chandra M. Kumar ◽  
Frédérique Servin

Major abdominal surgery and laparotomy are common procedures that are associated with a high risk of mortality and morbidity, especially in the elderly. Outcomes can be improved by formal risk stratification, appropriate perioperative resuscitation and optimization, early surgery, senior anaesthetist involvement, and careful postoperative critical. Assessment of dehydration is imperative because fluid losses are very common and may be difficult to measure. Hypothermia is common, and measures should be instituted to conserve heat loss. Use of nitrous oxide can cause bowel distension and should be avoided. Elderly patients should receive postoperative care in an environment that is appropriate to the degree of comorbidity and the type of surgery. Effective analgesia is known to improve outcome. Only experienced anaesthetists should manage major and emergency abdominal surgery.


2021 ◽  
Vol 8 (10) ◽  
pp. 209
Author(s):  
Aida Fages ◽  
Carme Soler ◽  
Nuria Fernández-Salesa ◽  
Giuseppe Conte ◽  
Massimiliano Degani ◽  
...  

Emergency abdominal surgery carries high morbidity and mortality rates in human medicine; however, there is less evidence characterising the outcome of these surgeries as a single group in dogs. The aim of the study was to characterise the clinical course, associated complications and outcome of dogs undergoing emergency abdominal surgery. A retrospective study was conducted. Dogs undergoing emergency laparotomy were included in the study. Logistic regression analysis was performed to identify variables correlated with death and complications. Eighty-two dogs were included in the study. The most common reason for surgery was a gastrointestinal foreign body. Overall, the 15-day mortality rate was 20.7% (17/82). The median (range) length of hospitalisation was 3 (0.5–15) days. Of the 82 patients, 24 (29.3%) developed major complications and 66 (80.5%) developed minor complications. Perioperative factors significantly associated with death included tachycardia (p < 0.001), hypothermia (p < 0.001), lactate acidosis (p < 0.001), shock index > 1 (p < 0.001), leukopenia (p < 0.001) and thrombocytopenia (p < 0.001) at admission, as well as intraoperative hypotension (p < 0.001) and perioperative use of blood products (p < 0.001). The results of this study suggest that mortality and morbidity rates after emergency abdominal surgery in dogs are high.


2015 ◽  
Vol 61 (3) ◽  
pp. 437-442 ◽  
Author(s):  
Jakub Kenig ◽  
Beata Zychiewicz ◽  
Urszula Olszewska ◽  
Marcin Barczynski ◽  
Wojciech Nowak

Author(s):  
Aida Fages ◽  
Carme Soler ◽  
Nuria Fernández-Salesa ◽  
Giuseppe Conte ◽  
Massimiliano Degani ◽  
...  

Emergency abdominal surgery carries high morbidity and mortality rates in human medicine; however, there is less evidence characterizing the outcome of these surgeries as a single group in dogs. The aim of the study was to characterize the clinical course, associated complications and outcome of dogs undergoing emergency abdominal surgery. A retrospective study was conducted. Dogs undergoing emergency laparotomy were included in the study. Logistic regression analysis was performed to identify variables correlated with death and complications. Eighty-two dogs were included in the study. The most common reason for surgery was gastrointestinal foreign body. Overall 15-day mortality rate was 20.7% (17/82). Median (range) length of hospitalization was 3 (0.5 - 15) days. Of the 82 patients, 24 (29.3%) developed major complications and 66 (80.5%) minor complications. Perioperative factors significantly associated with death included tachycardia (P &amp;lt; 0.001), hypothermia (P &amp;lt; 0.001), lactate acidosis (P &amp;lt; 0.001), shock index &amp;gt; 1 (P &amp;lt; 0.001), leukopenia (P &amp;lt; 0.001), thrombocytopenia (P &amp;lt; 0.001) at admission; intraoperative hypotension (P &amp;lt; 0.001) and perioperative use of blood products (P &amp;lt; 0.001). The results of this study suggest that mortality and morbidity rates after emergency abdominal surgery in dogs are high.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuanyuan Xu ◽  
Danqun Jin ◽  
Huan Ye ◽  
Youfeng Liang

Abstract Background Community-acquired infections of Pseudomonas aeruginosa (P. aeruginosa) occur very rarely. Case presentation P. aeruginos was detected in cultures of venous blood and peritoneal exudate of a newborn with 58 perforations in the small intestine. Intravenous administration of imipenem cilastratin sodium and emergency abdominal surgery were performed. The patient fully recovered and was discharged 17 days after the operation. Conclusions Mild symptoms of systemic infections in newborns may delay the diagnosis. Early detection and timely treatment are the key to improved prognosis.


Author(s):  
Mattia Portinari ◽  
Lara Bianchi ◽  
Alessandro De Troia ◽  
Giorgia Valpiani ◽  
Savino Spadaro ◽  
...  

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