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Int J Surg. 2014;12(4):315-9. doi: 10.1016/j.ijsu.2014.01.016. Epub 2014 Jan 31.

Early predictors for tissue healing deficit and leakage in geriatric critically ill patients receiving emergent abdominal surgery: a case control study.

Author information

  • 1Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan. Electronic address: rw114@mail.cmuh.org.tw.
  • 2Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linko, Taiwan. Electronic address: drfu5564@yahoo.com.tw.
  • 3Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan. Electronic address: hsiehchihsun@yahoo.com.tw.
  • 4Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan. Electronic address: traumawang@yahoo.com.tw.
  • 5Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan. Electronic address: carfishcat@yahoo.com.tw.
  • 6Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: howardcheng324@gmail.com.
  • 7Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: D11814@mail.cmuh.org.tw.

Abstract

BACKGROUND:

As our world ages and the elderly population grows. Surgery on the aged critically ill tend to result in additional morbidity and mortality. We sought to determine early predicting factors that were associated with postoperative leakage and tissue healing deficiency after emergent abdominal surgery in geriatric critically ill patients.

MATERIAL AND METHOD:

Retrospectively, geriatric critically ill patients received anticipated, single-stage emergent abdominal surgery via emergency room were enrolled. Patients who received only one definitive surgery during their hospital course were labeled as group A, patients received anticipated one-stage surgery and eventually with postoperative leakage and tissue healing deficiency were labeled as group B. The demographics and parameters were obtained for comparison.

RESULT:

There were 45 patients in group A, and 34 patients in group B. The mean age is 77.4 ± 6.1 years in Group A and 76.9 ± 8.5 years in Group B, the mean APACHE score was 20.3 ± 7.5 vs. 21.6 ± 7.7. There were no significances in age, gender, comorbidities, and physiological scores. There were significances in the persistent post-operative use of vasopressors and hypoalbuminemia. The 30-day mortality rate was 0% in group A and 38.2% in group B.

CONCLUSION:

Persistent post operative vasopressor use and hypoalbuminemia are associated with higher rate of morbidity and mortality after emergent abdominal surgery in geriatric critically ill patients. Early recognition is essential for proper management. Further studies are required for a better understanding in identifying risk factors.

Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

KEYWORDS:

Geriatric critical ill; Hypoalbuminemia; Vasopressor

PMID:
24486934
[PubMed - indexed for MEDLINE]
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