Early Risk Stratification and Mortality Prediction in Gastrointestinal Perforation: A Retrospective Cohort Study for...

Area of Science:

• Emergency Medicine
• Surgical Critical Care
• Gastroenterology

Background:

• Gastrointestinal perforation presents a significant surgical emergency with high mortality.
• Early risk stratification is crucial for improving outcomes in emergency surgical settings.

Purpose of the Study:

• To identify independent predictors of mortality in patients with gastrointestinal perforation.
• To develop a simplified predictive score for in-hospital mortality.

Main Methods:

• Retrospective observational cohort study of 166 adult patients with gastrointestinal perforation.
• Multivariable logistic regression analysis to identify mortality predictors.
• Development of a simplified bedside predictive score.

Main Results:

• In-hospital mortality was 22.3%.
• Independent predictors of mortality included increasing age, septic shock on admission, and intraoperative vasopressor use.
• A predictive score demonstrated good discrimination (AUC 0.83).

Conclusions:

• Mortality is associated with physiological derangement and patient frailty.
• Early identification of high-risk patients can aid perioperative risk stratification.
• The proposed score is preliminary and requires validation.