JMA journal · 2025
Predictive Impact of Peritoneal Computed Tomography Attenuation Values for the Severity of Upper Gastrointestinal Perforation.
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Tsujimoto Hironori, Kariya Risa, Fujishima Seiichiro, Suzuki Takafumi, Uehata Naoyuki, Yaguchi Yoshihisa, Kouzu Keita, Shinmoto Hiroshi, Ueno Hideki
Аннотация
INTRODUCTION: This study aimed to evaluate the peritoneal computed tomography (CT) attenuation values and investigate their predictive impact for the severity of peritonitis in patients with upper gastrointestinal tract (UGI) perforations.
METHODS: Overall, 112 consecutive patients with UGI perforations who underwent plain CT were included in this study. Peritoneal CT attenuation values expressed in Hounsfield units (HUs) were measured on a workstation and investigated in relation to laboratory data obtained on admission, severity of illness, and hospital mortality.
RESULTS: Peritoneal CT attenuation values were significantly negatively correlated with the Acute Physiology and Chronic Health Evaluation II (p < 0.01, R2 = 0.17) and sequential organ failure assessment (SOFA) (p < 0.01, R2 = 0.30) scores. Peritoneal CT attenuation values of hospital nonsurvivors (n = 7, 12.4 ± 11.0 HU) were significantly lower than those of hospital survivors (n = 105, 34.3 ± 15.8 HU). There was a significant negative correlation between peritoneal CT attenuation values, serum C-reactive protein levels (p < 0.01, R2 = 0.11), and the time after the onset of abdominal pain (p < 0.01, R2 = 0.08). Multivariate analysis revealed that the SOFA score was significantly associated with peritoneal CT attenuation values.
CONCLUSIONS: Evaluation of peritoneal CT attenuation values in patients with UGI perforation is simple and can be used to objectively assess the severity of peritonitis, which can serve as a reference for treatment strategies.
METHODS: Overall, 112 consecutive patients with UGI perforations who underwent plain CT were included in this study. Peritoneal CT attenuation values expressed in Hounsfield units (HUs) were measured on a workstation and investigated in relation to laboratory data obtained on admission, severity of illness, and hospital mortality.
RESULTS: Peritoneal CT attenuation values were significantly negatively correlated with the Acute Physiology and Chronic Health Evaluation II (p < 0.01, R2 = 0.17) and sequential organ failure assessment (SOFA) (p < 0.01, R2 = 0.30) scores. Peritoneal CT attenuation values of hospital nonsurvivors (n = 7, 12.4 ± 11.0 HU) were significantly lower than those of hospital survivors (n = 105, 34.3 ± 15.8 HU). There was a significant negative correlation between peritoneal CT attenuation values, serum C-reactive protein levels (p < 0.01, R2 = 0.11), and the time after the onset of abdominal pain (p < 0.01, R2 = 0.08). Multivariate analysis revealed that the SOFA score was significantly associated with peritoneal CT attenuation values.
CONCLUSIONS: Evaluation of peritoneal CT attenuation values in patients with UGI perforation is simple and can be used to objectively assess the severity of peritonitis, which can serve as a reference for treatment strategies.