Xu Xin, Dong Hai-Chang, Yao Zheng, Zhao Yun-Zhao
Department of General Surgery, Jiangning Hospital, Nanjing 210002, Jiangsu Province, China.
Department of General Surgery, Huaihe Hospital, Kaifeng 475000, Henan Province, China.
World J Clin Cases. 2020 Feb 26;8(4):670-678. doi: 10.12998/wjcc.v8.i4.670.
Sepsis is fatal in patients with gastrointestinal perforation (GIP). However, few studies have focused on this issue.
To investigate the risk factors for postoperative sepsis in patients with GIP.
This was a retrospective study performed at the Department of General Surgery in our treatment center. From January 2016 to December 2018, the medical records of patients with GIP who underwent emergency surgery were reviewed. Patients younger than 17 years or who did not undergo surgical treatment were excluded. The patients were divided into the postoperative sepsis group and the non-postoperative sepsis group. Clinical data for both groups were collected and compared, and the risk factors for postoperative sepsis were investigated. The institutional ethical committee of our hospital approved the study.
Two hundred twenty-six patients were admitted to our department with GIP. Fourteen patients were excluded: Four were under 17 years old, and 10 did not undergo emergency surgery due to high surgical risk and/or disagreement with the patients and their family members. Two hundred twelve patients were finally enrolled in the study; 161 were men, and 51 were women. The average age was 62.98 ± 15.65 years. Postoperative sepsis occurred in 48 cases. The prevalence of postoperative sepsis was 22.6% [95% confidence interval (CI): 17.0%-28.3%]. Twenty-eight patients (13.21%) died after emergency surgery. Multiple logistic regression analysis confirmed that the time interval from abdominal pain to emergency surgery [odds ratio (OR) = 1.021, 95%CI: 1.005-1.038, = 0.006], colonic perforation (OR = 2.761, CI: 1.821-14.776, = 0.007), perforation diameter (OR = 1.062, 95%CI: 1.007-1.121, = 0.027), and incidence of malignant tumor-related perforation (OR = 5.384, 95%CI: 1.762-32.844, = 0.021) were associated with postoperative sepsis.
The time interval from abdominal pain to surgery, colonic perforation, diameter of perforation, and the incidence of malignant tumor-related perforation were risk factors for postoperative sepsis in patients with GIP.
脓毒症在胃肠道穿孔（GIP）患者中是致命的。然而，很少有研究关注这个问题。
探讨GIP患者术后脓毒症的危险因素。
这是一项在我们治疗中心普通外科进行的回顾性研究。回顾了2016年1月至2018年12月期间接受急诊手术的GIP患者的病历。排除年龄小于17岁或未接受手术治疗的患者。将患者分为术后脓毒症组和非术后脓毒症组。收集并比较两组的临床资料，调查术后脓毒症的危险因素。我院机构伦理委员会批准了本研究。
226例GIP患者入住我科。14例患者被排除：4例年龄在17岁以下，10例因手术风险高和/或患者及其家属不同意而未接受急诊手术。最终212例患者纳入研究；男性161例，女性51例。平均年龄为62.98±15.65岁。48例发生术后脓毒症。术后脓毒症的患病率为22.6%[95%置信区间（CI）：17.0%-28.3%]。28例患者（13.21%）在急诊手术后死亡。多因素logistic回归分析证实，腹痛至急诊手术的时间间隔[比值比（OR）=1.021，95%CI：1.005-1.038，P=0.006]、结肠穿孔（OR=2.761，CI：1.821-14.776，P=0.007）、穿孔直径（OR=1.062，95%CI：1.007-1.121，P=0.027）以及恶性肿瘤相关穿孔的发生率（OR=5.384，95%CI：1.762-32.844，P=0.021）与术后脓毒症相关。
腹痛至手术的时间间隔、结肠穿孔、穿孔直径以及恶性肿瘤相关穿孔的发生率是GIP患者术后脓毒症的危险因素。
