Er Sadettin, Sevim Yusuf, Özden Sabri, Tikici Deniz, Yıldız Barış Doğu, Yüksel Bülent Cavit, Turan Umut Fırat, Tez Mesut
MD. Attending Physician, Department of Surgery, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
MD. Associate Professor, Department of Surgery, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
Sao Paulo Med J. 2019 Jul 15;137(2):132-136. doi: 10.1590/1516-3180.2018.0316240119.
Despite advances in surgical approaches, emergency colorectal surgery has high mortality and morbidity.
We aimed to create a simple and distinctive scoring system, for predicting mortality among patients undergoing emergency colorectal surgery.
Prediction model development study based on retrospective data-gathering.
Patients who underwent emergency colorectal surgery between March 2014 and December 2016 at a single tertiary-level referral center were included in our study. Patient demographics, comorbidities, type of surgery, etiology and laboratory and radiological findings were collected retrospectively and analyzed. A new clinical score (named the Numune emergency colorectal resection score) was constructed from the last logistic regression model, in which one point was assigned for the presence of each predictive factor.
138 patients underwent emergency colorectal surgery. These comprised 64 males (46.4%) and 74 females (53.6%), with a mean age of 64 years. Multivariate analysis revealed that blood urea nitrogen level > 65 mg/dl (odds ratio, OR: 8.03; 95% confidence interval, CI: 2.16-15.77), albumin level < 0.7 -mg/-dl (OR: 4.43; 95% CI: 1.96-14.39) and American Society of Anesthesiologists score ≥ 3 (OR: 3.47; 95% CI: 0.81-9.18) were associated with postoperative complications. The Numune score was graded from I to III. The risk of mortality was found to be 63.2% in the group with grade III, which accounted for 35.2% of the subjects. There were 37 postoperative deaths.
Surgeons need scoring systems, especially to predict postoperative mortality. We propose the Numune emergency colorectal resection score for emergency surgical procedures as a practical, usable and effective system for predicting postoperative morbidity.
尽管手术方法有所进步，但急诊结直肠手术的死亡率和发病率仍很高。
我们旨在创建一个简单且独特的评分系统，用于预测接受急诊结直肠手术患者的死亡率。
基于回顾性数据收集的预测模型开发研究。
纳入2014年3月至2016年12月在一家三级转诊中心接受急诊结直肠手术的患者。回顾性收集并分析患者的人口统计学资料、合并症、手术类型、病因以及实验室和影像学检查结果。根据最后一个逻辑回归模型构建了一个新的临床评分（命名为努姆内急诊结直肠切除评分），每个预测因素存在则计1分。
138例患者接受了急诊结直肠手术。其中男性64例（46.4%），女性74例（53.6%），平均年龄64岁。多因素分析显示，血尿素氮水平>65mg/dl（比值比，OR：8.03；95%置信区间，CI：2.16 - 15.77）、白蛋白水平<0.7mg/dl（OR：4.43；95%CI：1.96 - 14.39）以及美国麻醉医师协会评分≥3（OR：3.47；95%CI：0.81 - 9.18）与术后并发症相关。努姆内评分分为I至III级。III级组的死亡率为63.2%，该组占受试者的35.2%。术后有37例死亡。
外科医生需要评分系统，尤其是用于预测术后死亡率。我们提出将努姆内急诊结直肠切除评分用于急诊手术，作为预测术后发病率的实用、可用且有效的系统。
