Predictor of Mortality in Complicated Intraabdominal Infection Patients at Dr. Soetomo General Hospital Surabaya

Erwin Kurniawan; Marjono Dwi Wibowo; Edwin Danardono

doi:10.15562/bmj.v12i2.4584

Predictor of Mortality in Complicated Intraabdominal Infection Patients at Dr. Soetomo General Hospital Surabaya

Erwin Kurniawan ,

Marjono Dwi Wibowo ,

Edwin Danardono ,

pdf |
DOI: https://doi.org/10.15562/bmj.v12i2.4584 |
Published: 2023-08-09

Abstract

Link of Video Abstract: https://youtu.be/g_ys7cQCuDY

Background: Complicated intraabdominal infection (cIAI) is a surgical emergency reported to be a major contributor to non-traumatic mortality worldwide. Identifying the mortality risk before any operation is important in guiding clinical decision-making and informed patient consent about the risk of complicated intraabdominal infection (cIAI). The study aimed to develop a novel scoring system for predicting postoperative mortality in cIAI.

Methods: Data were collected retrospectively from all consecutive patients 396 patients met the inclusion criteria after excluding missing data undergoing cIAI surgery in Dr. Soetomo Hospital 2020 - 2022. Multivariate logistic regression analysis was performed to correlate the explanatory variable postoperative mortality. Data were analyzed using SPSS version 20.0 for Windows and MedCalc.

Results: Postoperative mortality rate cIAI was 32,2% (128 of 396), and variables identified as the strongest predictors of postoperative mortality were age > 60 y.o (OR 3,196), systolic blood pressure < 100 mmHg (OR 5,894), thrombocyte < 100.000 /uL (OR 5,593), albumin ≤ 2,9 g/dL (OR 6,764), total bilirubin > 1,8 mg/dL (OR 2,180), creatinine serum ≥ 1,58 mg/dL (OR 4,290), cancer comorbidity (OR 3,578), and appendix perforation as negative predictor (OR 5,853). These parameters were included in the prediction model of the novel simplified Airlangga Scoring System.

Conclusion: Despite the relatively low number of risk factors, the Airlangga score has been shown as a good predictor of postoperative mortality after cIAI. External validation is required in hospitals different from those in which the novel scoring system was developed.

References

Lalisang TJ, Mazni Y, Jeo WS, Marbun VM. Factor influencing outcome of source control in the management of complicated intra-abdominal infection in Cipto Mangunkusumo University Hospital. Formos J Surg 2019;52:169-74.
Sartelli M, Coccolini F, Kluger Y, Agastra E, Abu-zidan FM, El A, et al. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections. World J Emerg Surg. 2021;16(1):49.
Tolonen M, Coccolini F, Ansaloni L, Sartelli M, Roberts DJ, Mckee JL, et al. Getting the invite list right : a discussion of sepsis severity scoring systems in severe complicated intra-abdominal sepsis and randomized trial inclusion criteria. World J Emerg Surg. 2018;13:17.
Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Int J Obstet Anesth. 2016;25:75-78.
Nannapaneni R, Behari S, Todd NV. Surgical outcome in rheumatoid Ranawat Class IIIb myelopathy. Neurosurgery. 2005;56(4):706-715.
Nugraha GL, Septarendra D, Lesmana T. Comparative study of SOFA, WSESSSS, and CPIRO scoring systems as mortality predictors in a patient with complicated intra-abdominal infection. Bali Medical Journal. 2022;11(3):1397–1403.
Alvis BD, Hughes CG. Physiology Considerations in Geriatric Patients. Anesthesiol Clin. 2015;33(3):447-456.
Sirikurnpiboon S, Amornpornchareon S. Factors Associated with Perforated Appendicitis in Elderly Patients in a Tertiary Care Hospital. Surg Res Pract. 2015;2015:847681.
Luo X, Li L, Ou S, Zeng Z, Chen Z. Risk Factors for Mortality in Abdominal Infection Patients in ICU: A Retrospective Study From 2011 to 2018. Front Med. 2022;9:839284.
Venkatesan S, Myles PR, Manning HJ, Mozid AM, Andersson C, Jørgensen ME, et al. Cohort study of preoperative blood pressure and risk of 30-day mortality after elective non-cardiac surgery. Br J Anaesth. 2017;119(1):65–77.
Thompson K, Venkatesh B, Finfer S. Sepsis and septic shock: current approaches to management. Intern Med J. 2019;49(2):160–170.
Neumayer L, Hosokawa P, Itani K, El-Tamer M, Henderson WG, Khuri SF. Multivariable Predictors of Postoperative Surgical Site Infection after General and Vascular Surgery: Results from the Patient Safety in Surgery Study. J Am Coll Surg. 2007;204(6):1178–87.
Bendersky V, Sun Z, Adam MA, Rushing C, Kim J, Youngwirth L, et al. Determining the Optimal Quantitative Threshold for Preoperative Albumin Level Before Elective Colorectal Surgery. J Gastrointest Surg. 2017;21(4):692–699.
Rungsakulkij N, Vassanasiri W, Tangtawee P, Suragul W, Muangkaew P, Mingphruedhi S, et al. Preoperative serum albumin is associated with intra-abdominal infection following major hepatectomy. J Hepatobiliary Pancreat Sci. 2019;26(11):479–489.
Winangun IMA, Aryana IGPS, Astika IN, Kuswardhani RAT. Relationship of albumin serum levels and Neutrophil-Lymphocyte Ratios (NLR) on activities of daily living elderly patients with delirium at Sanglah General Hospital, Bali, Indonesia. Bali Medical Journal. 2020;9(1):201-207.
Muthiah U, Rostini T, Tristina N. The role of serum albumin level within the first 24-hours of hospitalization to the mortality risk in burn patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Bali Medical Journal. 2019;8(2):408-413.
Bawazir LAA. Limitations of serum albumin level as a marker of nutritional status in hemodialysis patients. Bali Medical Journal. 2020;9(1):149-154.

[1] Lalisang TJ, Mazni Y, Jeo WS, Marbun VM. Factor influencing outcome of source control in the management of complicated intra-abdominal infection in Cipto Mangunkusumo University Hospital. Formos J Surg 2019;52:169-74.

[2] Sartelli M, Coccolini F, Kluger Y, Agastra E, Abu-zidan FM, El A, et al. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections. World J Emerg Surg. 2021;16(1):49.

[3] Tolonen M, Coccolini F, Ansaloni L, Sartelli M, Roberts DJ, Mckee JL, et al. Getting the invite list right : a discussion of sepsis severity scoring systems in severe complicated intra-abdominal sepsis and randomized trial inclusion criteria. World J Emerg Surg. 2018;13:17.

[4] Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Int J Obstet Anesth. 2016;25:75-78.

[5] Nannapaneni R, Behari S, Todd NV. Surgical outcome in rheumatoid Ranawat Class IIIb myelopathy. Neurosurgery. 2005;56(4):706-715.

[6] Nugraha GL, Septarendra D, Lesmana T. Comparative study of SOFA, WSESSSS, and CPIRO scoring systems as mortality predictors in a patient with complicated intra-abdominal infection. Bali Medical Journal. 2022;11(3):1397–1403.

[7] Alvis BD, Hughes CG. Physiology Considerations in Geriatric Patients. Anesthesiol Clin. 2015;33(3):447-456.

[8] Sirikurnpiboon S, Amornpornchareon S. Factors Associated with Perforated Appendicitis in Elderly Patients in a Tertiary Care Hospital. Surg Res Pract. 2015;2015:847681.

[9] Luo X, Li L, Ou S, Zeng Z, Chen Z. Risk Factors for Mortality in Abdominal Infection Patients in ICU: A Retrospective Study From 2011 to 2018. Front Med. 2022;9:839284.

[10] Venkatesan S, Myles PR, Manning HJ, Mozid AM, Andersson C, Jørgensen ME, et al. Cohort study of preoperative blood pressure and risk of 30-day mortality after elective non-cardiac surgery. Br J Anaesth. 2017;119(1):65–77.

[11] Thompson K, Venkatesh B, Finfer S. Sepsis and septic shock: current approaches to management. Intern Med J. 2019;49(2):160–170.

[12] Neumayer L, Hosokawa P, Itani K, El-Tamer M, Henderson WG, Khuri SF. Multivariable Predictors of Postoperative Surgical Site Infection after General and Vascular Surgery: Results from the Patient Safety in Surgery Study. J Am Coll Surg. 2007;204(6):1178–87.

[13] Bendersky V, Sun Z, Adam MA, Rushing C, Kim J, Youngwirth L, et al. Determining the Optimal Quantitative Threshold for Preoperative Albumin Level Before Elective Colorectal Surgery. J Gastrointest Surg. 2017;21(4):692–699.

[14] Rungsakulkij N, Vassanasiri W, Tangtawee P, Suragul W, Muangkaew P, Mingphruedhi S, et al. Preoperative serum albumin is associated with intra-abdominal infection following major hepatectomy. J Hepatobiliary Pancreat Sci. 2019;26(11):479–489.

[15] Winangun IMA, Aryana IGPS, Astika IN, Kuswardhani RAT. Relationship of albumin serum levels and Neutrophil-Lymphocyte Ratios (NLR) on activities of daily living elderly patients with delirium at Sanglah General Hospital, Bali, Indonesia. Bali Medical Journal. 2020;9(1):201-207.

[16] Muthiah U, Rostini T, Tristina N. The role of serum albumin level within the first 24-hours of hospitalization to the mortality risk in burn patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Bali Medical Journal. 2019;8(2):408-413.

[17] Bawazir LAA. Limitations of serum albumin level as a marker of nutritional status in hemodialysis patients. Bali Medical Journal. 2020;9(1):149-154.

Predictor of Mortality in Complicated Intraabdominal Infection Patients at Dr. Soetomo General Hospital Surabaya

Abstract

References

How to Cite

Search Panel