Evaluation of sequential organ failure assessment score for patients with strangulation ileus

Sumi, Toshiyuki; Katsumata, Kenji; Tsuchida, Akihiko; Sonoda, Ichiro; Shimazu, Motohide; Aoki, Tatsuya

doi:10.1007/s00423-008-0396-1

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…demonstrated a strong correlation between strangulated ileus, mortality and the SOFA score. [ 9 ] Consistent with these findings, our study showed a significantly higher SOFA score in the ICU-requiring group. This may be attributed to partial organ dysfunction caused by systemic inflammatory mediators released from the small intestine after partial ischaemia.…”

Section: Discussionsupporting

confidence: 89%

“…These factors can lead to bacterial translocation, electrolyte imbalances and even sepsis. [ 9 ] Identifying high-risk patients and predicting the need for ICU admission can facilitate closer monitoring and potentially reduce mortality and morbidity. In our study, we aimed to predict post-admission ICU requirement in ASBO patients using the SOFA score, CCI and CRP/albumin ratio.…”

Section: Discussionmentioning

confidence: 99%

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Predictive markers in estimating the need for early intensive care in patients with adhesive small bowel obstruction in the emergency department

Teke,

Besler

2023

Journal of Minimal Access Surgery

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Introduction: Adhesive small-bowel obstruction (ASBO) is a common condition requiring emergency room admission, and predicting the need for intensive care unit (ICU) hospitalisation is crucial for optimal patient management. This study aimed to investigate the predictive value of various scores and indices in determining ICU requirements in patients with ASBO. Patients and Methods: Seventy patients diagnosed with ASBO and managed nonoperatively were included in the study. Data on patient demographics, laboratory values, imaging findings, previous hospitalisations and comorbidities were collected. The Sequential Organ Failure Assessment (SOFA) score, Charlson Comorbidity Index (CCI) score and C-reactive protein (CRP)/albumin ratio were calculated. Patients were categorised into ICU and non-ICU groups for analysis. Results: The ICU group comprised patients with higher number of previous ASBO hospitalisations and longer hospitalisation days. Serum albumin levels were significantly lower and the maximum small-bowel horizontal diameter was significantly higher in the ICU group. The SOFA score and CCI score were significantly higher in the ICU group. The CRP/albumin ratio showed a trend towards significance. Conclusion: The number of days since the last stool discharge, SOFA score and CCI score demonstrated significant associations with ICU requirements in ASBO patients. These findings highlight the importance of assessing organ dysfunction, comorbidities and gastrointestinal function during patient triage. Our study provides valuable insights into predicting ICU need in ASBO patients, aiding in resource allocation and patient management.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Predictive markers in estimating the need for early intensive care in patients with adhesive small bowel obstruction in the emergency department

Teke,

Besler

2023

Journal of Minimal Access Surgery

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A novel discriminant formula for the prompt diagnosis of strangulated bowel obstruction

et al. 2021

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Clinicopathological evaluation of anoxic mucosal injury in strangulation ileus

Takahashi

Akagi

Tanaka³

et al. 2014

BMC Surg

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BackgroundIn patients with strangulation ileus, the severity of bowel ischemia is unpredictable before surgery. To consider a grading scale of anoxic damage, we evaluated the pathological findings and investigated predictive factors for bowel gangrene.MethodsWe assessed 49 patients with strangulation ileus who underwent a laparotomy between January 2004 and November 2012. Laboratory tests and the contrast computed tomography (CT) were evaluated before surgery. According to the degree of mucosal degeneration, we classified anoxic damages into the following 3 grades. Ggrade 1 shows mild mucosal degeneration with extended subepithelial space. Grade 2 shows moderate degeneration and mucosal deciduation with residual mucosa on the muscularis mucosae. Grade 3 shows severe degeneration and mucosal digestion with disintegration of lamina propria.ResultsResected bowel specimens were obtained from the 36 patients with severe ischemia, while the remaining 13 patients avoided bowel resection. The mucosal injury showed grade 1 in 11 cases, grade 2 in 10 cases, and grade 3 in 15 cases. The patients were divided into two groups. One group included grade 1 and non-resected patients (n = 24) while the other included grades 2 and 3 (n = 25). When comparing the clinical findings for these groups, elevated creatine kinase (P = 0.017), a low base excess (P = 0.021), and decreased bowel enhancement on the contrast CT (P = 0.001) were associated with severe mucosal injury.ConclusionIn strangulation ileus, anoxic mucosal injury progresses gradually after rapid spreading of bowel congestion. Before surgical intervention, creatine kinase, base excess, and bowel enhancement on the contrast CT could indicate the severity of anoxic damage. These biomarkers could be the predictor for bowel resection before surgery.

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Evaluation of sequential organ failure assessment score for patients with strangulation ileus

Cited by 4 publications

References 6 publications

Predictive markers in estimating the need for early intensive care in patients with adhesive small bowel obstruction in the emergency department

Predictive markers in estimating the need for early intensive care in patients with adhesive small bowel obstruction in the emergency department

A novel discriminant formula for the prompt diagnosis of strangulated bowel obstruction

Clinicopathological evaluation of anoxic mucosal injury in strangulation ileus

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