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

Shih-Chi Wu, Chih-Yuan Fu, Chi-Hsun Hsieh, Yu-Chun Wang, Hung-Chieh Lo, Han-Tsung Cheng, Chia-Wei Tzeng

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

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. © 2014 Surgical Associates Ltd.
Original languageEnglish
Pages (from-to)315-319
Number of pages5
JournalInternational Journal of Surgery
Volume12
Issue number4
DOIs
Publication statusPublished - 2014
Externally publishedYes

Keywords

  • Geriatric critical ill
  • Hypoalbuminemia
  • Vasopressor
  • adrenalin
  • dopamine
  • noradrenalin
  • abdominal surgery
  • aged
  • anastomosis leakage
  • APACHE
  • article
  • controlled study
  • critically ill patient
  • emergency ward
  • evisceration
  • female
  • geriatric care
  • geriatric patient
  • healing
  • human
  • intensive care
  • intestine perforation
  • ischemia
  • laparoscopic surgery
  • major clinical study
  • male
  • morbidity
  • mortality
  • operative site bleeding
  • postoperative complication
  • postoperative hemorrhage
  • priority journal
  • retrospective study
  • wound dehiscence
  • abdomen
  • age
  • case control study
  • critical illness
  • geriatrics
  • laparotomy
  • Postoperative Complications
  • predictive value
  • procedures
  • reoperation
  • surgery
  • very elderly
  • wound healing
  • Abdomen
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Critical Illness
  • Female
  • Geriatrics
  • Humans
  • Laparotomy
  • Male
  • Predictive Value of Tests
  • Reoperation
  • Wound Healing

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