Kryvoruchko IA* and Olefir OS
Kharkiv National Medical University of the Ministry of Health of Ukraine, Kharkiv, Ukraine
*Corresponding Author: Kryvoruchko IA, Kharkiv National Medical University of the Ministry of Health of Ukraine, Kharkiv, Ukraine.
Received: September 21, 2021; Published: October 06, 2021;
Background: An urgent task is to determine the prognosis of mortality in patients with complicated intra-abdominal infection at the stages of their complex treatment in the context of emergency abdominal surgery.
Methods: This study was based on data comparing severity indicators in 255 patients of both sexes, aged 18 to 70 years, who were operated on for secondary peritonitis in the same surgical hospital.
Results: By the criteria of Sepsis-3 patients without sepsis were 119 (46.7%), with abdominal sepsis was diagnosed in 110 (43.1%), and septic shock was diagnosed in 26 (10.2%). The main finding of this study is that increased leukocyte, lactate, C-reactive protein levels and decreased systolic blood pressure, abdominal perfusion pressure 72 hours postoperatively were predictive factors for patients. It was shown that there was a strong negative relationship between intra-abdominal pressure and abdominal perfusion pressure (r = - 0.83, p = 0.000), a positive correlation between the surgical approach (r = 0.88; p = 0.000) and these increases of pressure values were correlated with the deterioration of the patients' condition according to the APACHE II and SOFA scores severity. It was also confirmed that the risk of developing abdominal compartment syndrome statistically significantly (p = 0.000) increases in the presence of intestinal paresis (odd ratio = 3.3, 95% CI 1.5-3.9), the numbers of re-laparotomies (odd ratio = 7.84, 95% CI 4.8-8.5), and massive infusion therapy (odd ratio = 1.8, 95% CI 1.1-2.9), and its will be able to lead to the development of acute respiratory distress syndrome (odd ratio = 11.6, 95% CI 8.7-14.1), cardiogenic pulmonary edema after surgery (odd ratio = 2.6, 95% CI 1.8-3.9), and postoperative delirium (odd ratio = 2.2, 95% CI 1.6-3.1).
Conclusions: Evaluation of effective biomarkers of patient severity had to use in emergency abdominal surgery to improve treatment outcomes.
Keywords: Generalized Intra-abdominal Infection; Abdominal Sepsis; Septic Shock; Biomarkers; Intra-Abdominal Hypertension; Abdominal Compartment Syndrome; Results
Citation: Kryvoruchko IA and Olefir OS. “The Assessment of the Severity of Patients with Generalized Intra-abdominal Infection: An Emphasis on the Predictive Value of Reducing Abdominal Perfusion Pressure in the Complex Treatment of Patients”.Acta Scientific Medical Sciences 5.11 (2021): 17-26 .
Copyright: © 2021 Kryvoruchko IA and Olefir OS. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.