Clinical Assessment and Risk Management of Colorectal Perforation in our Hospital

Abstract

[Purpose] In patients who underwent emergency surgery for colorectal perforation at our hospital, we examined the clinical matters and factors that might reflect the prognosis, and reviewed the factors that may be important for risk management. [Subjects] The subjects were 43 patients with colorectal perforation who were treated at our hospital between July 2005 and January 2011. [Results] The SOFA, APACHE II and POSSUM scores, as well as the Mannheim Peritonitis Index (MPI), were significantly higher in the non-survivor group than in the survivor group. The prognosis was significantly less favorable in patients who were in shock before surgery, patients with preoperative BE values of less than -5.0mmol/L, and patients in whom the interval from the onset to the start of surgery was 24 hours or more. Furthermore, the mortality rate was higher in patients who were referred from hospitals in adjacent areas and those with serious underlying diseases. [Discussion] It may be important to shorten the interval from the onset to the start of surgery and promptly evaluate the clinical condition before surgery as prognostic factors in patients with colorectal perforation.