Abstract
【Objective】To identify the prognostic factors in patients with colorectal perforation and investigate the indications and efficacy of endotoxin adsorption therapy (hereinafter, PMX-DHP). 【Subjects and methods】The subjects studied were 54 patients with colorectal perforation treated at our hospital during the 5-year period from April 2003 through March 2008. Nine preoperative factors and 6 postoperative factors were identified and subjected to statistical analysis. 【Results】Based on the results of the multivariate analysis, 4 factors independently related to poor prognosis were identified, as follows: (1) preoperative shock index ≥1.1; (2) systolic blood pressure immediately after surgery &le80 mmHg; (3) absolute need for nor-adrelanine therapy after surgery; (4) decrease of the platelet count on the day after the surgery ≥40%. All the patients who died fulfilled at least 2 of the 4 aforementioned factors. 【Discussion】PMX-DHP is considered for patients with the most serious colorectal perforation. Presence of at least 2 of the 4 poor prognostic factors mentioned above is considered as an indication for commencing PMX-DHP.
