BACKGROUND: Duration of surgical therapy and the number of surgical revisions performed to control the focus may be important prognostic variables. Association of such time-dependent therapies with survival, however, has not yet been studied. METHODS: We analyzed survival times of adult patients (n = 283) who were suffering from secondary peritonitis and associated organ failure. Cox-type additive hazard regression models were used to analyze associations of surgical variables with survival time. RESULTS: Seventy-two patients (25.4%) survived the period of excess mortality after intensive care unit admission. A total of 79.5% of the 283 patients required one or more surgical revisions. Besides the underlying disease and disease severity at intensive care unit admission, there was a nonlinear smoothed association between a poorer outcome and the duration of surgical therapy, and the number of surgical revisions. For the latter, hazard ratios increased sharply between 1 and 5 revisions, and remained largely constant later on. CONCLUSIONS: In critically ill patients with peritonitis, a long therapy and the necessity for a high number of reoperations is related inversely to acute survival.
BACKGROUND: Duration of surgical therapy and the number of surgical revisions performed to control the focus may be important prognostic variables. Association of such time-dependent therapies with survival, however, has not yet been studied. METHODS: We analyzed survival times of adult patients (n = 283) who were suffering from secondary peritonitis and associated organ failure. Cox-type additive hazard regression models were used to analyze associations of surgical variables with survival time. RESULTS: Seventy-two patients (25.4%) survived the period of excess mortality after intensive care unit admission. A total of 79.5% of the 283 patients required one or more surgical revisions. Besides the underlying disease and disease severity at intensive care unit admission, there was a nonlinear smoothed association between a poorer outcome and the duration of surgical therapy, and the number of surgical revisions. For the latter, hazard ratios increased sharply between 1 and 5 revisions, and remained largely constant later on. CONCLUSIONS: In critically illpatients with peritonitis, a long therapy and the necessity for a high number of reoperations is related inversely to acute survival.
Authors: A Hecker; B Hecker; K Kipfmüller; J Holler; E Schneck; M Reichert; M A Weigand; W Padberg; M Hecker Journal: Med Klin Intensivmed Notfmed Date: 2014-09 Impact factor: 0.840
Authors: Yoann Launey; Benjamin Duteurtre; Raphaëlle Larmet; Nicolas Nesseler; Audrey Tawa; Yannick Mallédant; Philippe Seguin Journal: World J Crit Care Med Date: 2017-02-04
Authors: Rainer Grotelüschen; Lena M Heidelmann; Marc Lütgehetmann; Nathaniel Melling; Matthias Reeh; Tarik Ghadban; Anna Dupree; Jakob R Izbicki; Kai A Bachmann Journal: Sci Rep Date: 2020-10-29 Impact factor: 4.379