Prognostic signs in abdominal surgery patients treated in the intensive care unit

To determine which factors had correlation with mortality during intensive care, 300 consecutive admissions to the intensive care unit in 286 critically ill patients requiring abdominal surgery were analyzed. The follow-up was one year. On admission, before any treatment was given, disturbances of vital functions (circulation, respiration, fluid- and acid-base balance, renal function, consciousness and other special disturbances) were classified into three grades according to their severity. The increase in the grade of severity, or especially in the sum of the grades of disturbances in various vital functions, correlated well with the mortality rate. Deviations in several biochemical parameters (e.g. serum sodium and potassium concentrations and serum osmolality) during intensive care were associated with an increase in mortality rate, even where these parameters were abnormal for only a short time and were later brought within normal range. With stepwise multiple discriminant analysis of model including 13 variables was formed to identify survivors and nonsurvivors. The strongest predictors of fatal outcome in this analysis were cirrhosis, increasing are and the sum of severity grades of disturbances in vital functions on admission.