Coagulopathy of lower gastrointestinal perforation in the elderly

Abstract

Introduction: Lower gastrointestinal perforation is one of the most common conditions causing sepsis. In this study, we evaluated coagulopathy in the elderly with lower gastrointestinal perforation. Methods: Patients with lower gastrointestinal perforation admitted to our ICU post emergency surgery were enrolled from April 2011 to March 2017. They were classified into the elderly (aged ≥ 75 years) and non-elderly (aged < 75 years) groups. The two groups were compared in terms of coagulation and fibrinolysis markers, DIC score, and SOFA score on days 0, 1, and 2 of ICU admission. Additionally, we evaluated the 28-day survival rate. Results: Overall, 46 patients were included in the study, 23 in the elderly group and 23 in the non-elderly group. DIC scores on days 0 and 1 were significantly higher in the elderly group than in the non-elderly group (both P<0.01), and SOFA score on day 1 was significantly higher in the elderly group than in the non-elderly group (P<0.05). There was no significant difference between two groups in 28-day survival rate [65％ (15/23) vs. 83％ (19/23), P＝0.18; log-rank test, P＝0.17]. Conclusions: Lower gastrointestinal perforation in elderly patients tends to be complicated by coagulopathy.