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Revista Cubana de Cirugía

On-line version ISSN 1561-2945

Abstract

SIERRA, Reinaldo Elías et al. Factors related to multi-organ failure in patients with peritonitis. Rev Cubana Cir [online]. 2019, vol.58, n.4  Epub May 25, 2020. ISSN 1561-2945.

Introduction:

Determining the prognosis of the patient with secondary diffuse peritonitis is a challenge for surgeons and intensivists.

Objective:

To identify the factors related to the risk of multiple organ failure in patients with secondary diffuse peritonitis admitted to the intensive care unit of the Hospital “Dr. Agostinho Neto”.

Methods:

A case study (patients with peritonitis and multi-organ failure n = 68) and controls (patients with peritonitis without multi-organ failure n = 47), in the period 2017-2018, was performed. 64 variables that characterized the patient or peritonitis were analyzed, and their association with the risk of the patient to present multiple organ failure was calculated.

Results:

The variables most associated with this risk were: anesthetic risk 3 or more according to the American Society of Anesthesia classification (odds ratio = 47.7), acid-basic / electrolyte imbalance (odds ratio = 22.6), hyperglycemia 10 mmol / l or more in non-diabetics (odds ratio = 15.5), persistent reflex paralytic ileus (odds ratio = 13.6), respiratory distress (odds ratio = 11.8), use of invasive mechanical ventilation (odds ratio = 11.8), Sequential [Sepsis-Related] Organ Failure Assessment 4 points or more (odds ratio = 10.2), treatment with open abdomen (odds ratio = 9.0), Acute Physiology and Chronic Health Evaluation II scale 15 15 points or more (odds ratio = 8.9), septic shock (odds ratio = 8.6).

Conclusions:

The factors associated with the presentation of multi-organ failure were identified, which made possible the design of a predictive scale of this failure in the patient with secondary diffuse peritonitis.

Keywords : peritonitis; forecast; multi-organ failure.

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