Volume 25, Issue 114, August 2021

A focus on abdominal sepsis: The problem of prognostic markers

Kryvoruchko Igor Andreevich^1♦, Sykal Nikolaj Alexandrovich², Yevtushenko Olexander Vasyliovych³, Riabtsev Roman Sergiiovych⁴

¹MD, Professor, Head of Department of Surgery No.2 of Kharkiv National Medical University, Kharkiv, Ukraine
²PhD, Assistant Professor of Department of Surgery No.2 of Kharkiv National Medical University, Kharkiv, Ukraine
³Graduate student of Department of Surgery No.2 of Kharkiv National Medical University, Kharkiv, Ukraine
⁴Senior Researcher at Zaitsev Institute of General and Emergency Surgery of National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine

^♦Corresponding author
MD, Professor, Head of Department of Surgery No.2 of Kharkiv National Medical University, Kharkiv, Ukraine;

ABSTRACT

Background: Determining the prognosis of mortality from abdominal sepsis in patients with one surgical intervention is an urgent problem. Methods: It study was based on data from comparing of severity scores in 136 patients with abdominal sepsis who were operated one time with secondary peritonitis and the condition was assessed before surgery and after 72 h using most significant indicators. Results: According to the goals and objectives of the study all patients were divided according to the severity of the condition which was determined by the criteria of Sepsis-3: abdominal sepsis was diagnosed in 110 (80.9%), and septic shock in 26 (19.1%) The main finding of this study is that an increase of WBC count, lactate, C-reactive protein levels, and a decrease systolic blood pressure, abdominal perfusion pressure after 72 h from the surgery were prognostic factors for patients with adverse outcome. It should be noted that qSOFA had the optimal cutoff value 2.5 points before surgery by criterion positive outcome/adverse outcome (AUC 0.842) with high sensitivity (93.9%) and low specificity (60.9%); APACHE II score had the optimal cutoff value 15.5 points (AUC 0.808), and SOFA score had the optimal cutoff value 9.5 points (AUC 0.754). In 72 h after surgery, the scores APACHE II (AUC 0.817) and SOFA (AUC 0.892) with the optimal cutoff 21.5 and 11.5 points had a good predictive value for the criterion positive outcome/adverse outcome, respectively. Conclusions: The assessment of effective biomarkers has made it possible to personalize surgical tactics and improve outcomes of the treatment.

Keywords: abdominal sepsis, definition of sepsis-3, biomarkers, severity rating scales, prediction of mortality, results.

Medical Science, 2021, 25(114), 2068-2076

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