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American journal of surgery · 2025

Extra-abdominal CT imaging indicates increased severity of illness in advanced age patients requiring emergency abdominal surgery.

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Malhotra Lavina, Stephen Andrew H, Goosman Madeline, Aluisio Adam R, Arafeh Mohammed, Adams Charles A, Leuckel Stephanie N, Emigh Brent, Hall Benjamin M, Heffernan Daithi S

Аннотация

BACKGROUND: Abdominal sepsis frequently causes neurologic and pulmonary dysfunction among geriatric patients, We hypothesize that patients with abdominal sepsis who undergo extra-abdominal imaging have a greater burden of illness.

METHODS: Patients 65 years and older that underwent emergency abdominal surgery for sepsis were divided into those with abdominal only(AbdCT) versus abdominal and extra-abdominal(ExtraCT) imaging.

RESULTS: ExtraCT patients(N ​= ​30) compared to AbdCT(N ​= ​97) had higher rates of dementia(13.3 ​% versus 3.3 ​%; p ​= ​0.03), diabetes(93.3 ​% versus 60.1 ​%; p ​< ​0.01 and COPD(70 ​% versus 29.9 ​%; p ​< ​0.01) but lower rates of abdominal pain as chief complaint (23.3 ​% versus 81.4 ​%; p ​< ​0.01) and higher rates of being qSOFA positive (33.3 ​% vs 7.2 ​%; p ​< ​0.05). Importantly, time to OR was not different between groups. ExtraCT patients had higher rates of 30-day mortality (33.3 ​% vs 5.2 ​%; p ​< ​0.01). Extra-abdominal CT imaging was associated with increased risk of mortality (OR ​= ​5.4; 95 %CI ​= ​1.4-20.1).

CONCLUSIONS: ExtraCT among geriatric patients with abdominal emergencies is a marker of severity of illness and should guide end-of-life decision making.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты