2017 Volume 41 Issue 6 Pages 891-896
We investigated the prediction of postoperative shock using preoperative and intraoperative factors in 176 patients who underwent surgery for colorectal perforation accompanied by diffuse peritonitis at our department from April 2007 to March 2015. Patients given catecholamines after surgery were classified as the catecholamine group, others as the non- catecholamine group. The following 11 items were investigated as predictors: age (≥ 80 years), severity of peritoneal contamination, time from the onset of abdominal pain (≥ 12 hours), presence/absence of chronic renal failure, presence/absence of steroid use, mean blood pressure (< 70 mmHg), presence/absence of systemic inflammatory response syndrome, white blood cell count (<4,000/μL), platelet count (<150,000/μL), serum total protein (<5g/dL), and sequential organ failure assessment (SOFA) score (≥ 3). Univariate analysis showed the severity of peritoneal contamination, mean blood pressure, white blood cell count, serum total protein, and the SOFA score to correlate with shock occurrence. Multivariate analysis of these 5 items revealed the mean blood pressure (odds ratio, 8.46; p=0.0003), white blood cell count (odds ratio, 4.33; p=0.0003), and serum total protein level (odds ratio, 7.51; p=0.0021) to be independent risk factors. Careful postoperative management is required because of the poor prognosis in complicated postoperative shock.
