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Esophageal Perforation-II: Clinical Manifestations and Management

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Clinical Manifestations:

Esophageal Perforation-I: Introduction

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Related Experiment Video

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Intestinal Stem Cell Isolation and Culture in a Porcine Model of Segmental Small Intestinal Ischemia

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Survival after intestinal perforation: can it be predicted?

Celestine S Tung¹, Charlotte C Sun, Matthew P Schlumbrecht

¹Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1362, Houston, TX 77030, USA.

Gynecologic Oncology

|September 22, 2009

Summary

High morbidity and mortality from intestinal perforation in gynecologic oncology patients can be predicted. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score is a significant factor for survival, aiding treatment planning.

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Area of Science:

Gynecologic Oncology
Surgical Complications
Critical Care Medicine

Background:

Intestinal perforation presents a significant challenge in gynecologic oncology, associated with substantial morbidity and mortality.
Identifying prognostic factors is crucial for optimizing treatment strategies and improving patient outcomes.

Purpose of the Study:

To investigate factors associated with survival following intestinal perforation in gynecologic oncology patients.
To determine the utility of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in risk stratification.

Main Methods:

Retrospective review of 53 gynecologic oncology patients with intestinal perforation (1993-2007).
Collection of demographic, cancer history, clinical, and management data; calculation of APACHE II scores.
Survival analysis using Kaplan-Meier, Cox proportional hazard models, t-tests, and chi(2) analysis.

Main Results:

APACHE II score, disease status, BMI, and perforation treatment were significant prognostic factors.
Multivariate analysis identified APACHE II score as the sole significant predictor of mortality.
Median survival was 28.13 months for APACHE II <15 versus 2.90 months for APACHE II >=15 (P<0.0001).

Conclusions:

The APACHE II score is a critical tool for risk stratification in gynecologic oncology patients with intestinal perforation.
Incorporating APACHE II scores into clinical assessment can guide treatment planning and improve patient management.