Medical Research Center of Oulu, Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu, Finland.
Department of Surgery, Oulu University Hospital, Oulu, Finland.
Acta Anaesthesiol Scand. 2022 Sep;66(8):954-960. doi: 10.1111/aas.14103. Epub 2022 Jun 19.
Outcomes after emergency laparotomy (EL) are poor. These patients are often admitted to an intensive care unit (ICU). This study explored outcomes in patients who were admitted to an ICU within 48 h after EL.
This retrospective single-center registry study included all patients over 16 years of age that underwent an EL and were admitted to an ICU within 48 h after surgery in Oulu University Hospital, Finland between January 2005 and May 2015. Survival was followed until the end of 2019.
We included 525 patients. Hospital mortality was 13.3%, 30-day mortality was 17.3%, 90-day mortality was 24.2%, 1-year mortality was 33.0%, and 5-year mortality was 59.4%. Survivors were younger (57 [45-70] years) than the non-survivors (73 [62-80] years; p < .001). According to the Cox regression model, death during the follow-up was associated with age, APACHE II-score, lower postoperative CRP levels and platelet count of the first postoperative day, and the admission from the post-anesthesia care unit (PACU) to the ICU instead of direct ICU admission.
Age, high APACHE II-score, low CRP and platelet count, and admission from the PACU to the ICU associated with mortality after EL in patients admitted to an ICU within 48 h after EL.
急诊剖腹手术后（EL）的结果较差。这些患者通常会被收入重症监护病房（ICU）。本研究探讨了在 EL 术后 48 小时内被收入 ICU 的患者的结果。
这是一项回顾性单中心登记研究，纳入了 2005 年 1 月至 2015 年 5 月期间在芬兰奥卢大学医院接受 EL 并在术后 48 小时内被收入 ICU 的所有年龄在 16 岁以上的患者。生存随访至 2019 年底。
我们纳入了 525 名患者。院内死亡率为 13.3%，30 天死亡率为 17.3%，90 天死亡率为 24.2%，1 年死亡率为 33.0%，5 年死亡率为 59.4%。存活者比非存活者更年轻（57 [45-70] 岁比 73 [62-80] 岁；p<0.001）。根据 Cox 回归模型，随访期间的死亡与年龄、APACHE II 评分、术后 CRP 水平和术后第 1 天血小板计数较低以及从麻醉后监护病房（PACU）转至 ICU 而不是直接收入 ICU 有关。
年龄、高 APACHE II 评分、低 CRP 和血小板计数以及从 PACU 转至 ICU 与 EL 术后 48 小时内收入 ICU 的患者的死亡率相关。
