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      Prognostic value of APTT combined with fibrinogen and creatinine in predicting 28-Day mortality in patients with septic shock caused by acute enteric perforation

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          Abstract

          Background

          Septic shock is one of the leading causes of mortality in intensive care units. This retrospective study was carried out to evaluate the association of clinical available factors with 28-day mortality.

          Patients and method

          In this observational study, patients with perioperative septic shocks secondary to intra-abdominal infection caused by enteric perforation were included. A total of 328 sepsis patients were admitted to the surgical intensive care units from January 2012 to December 2016. A total of 138 patients met the enrolment criteria and were included in the study. The data of demographic, clinical and laboratory were all recorded.

          Result

          All these 138 patients received abdominal surgery prior to surgical intensive care units caused by acute enteric perforation. These patients were all met the diagnostic criteria of septic shock according to Sepsis-3. Statistical analysis showed that lactic acid, blood platelet, fibrinogen, creatinine and activated partial thromboplastin time were found to be associated with 28-day mortality. A combination of serum activated partial thromboplastin time combined with fibrinogen and creatinine could predict in-hospital 28-day mortality. The area under the curve of serum activated partial thromboplastin time combined with fibrinogen and creatinine is 0.875 (0.806–0.944).

          Conclusion

          In conclusion, this pilot study demonstrated that these factors can predict the prognosis of septic shock caused by enteric perforation. In order to reduce the mortality, surgeons and intensive care units physician may consider these data in perioperative period.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12893-023-02165-6.

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          Most cited references34

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          The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

          Mervyn Singer, Clifford S Deutschman, Christopher Warren Seymour … (2016)
          Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination.
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            Assessment of Global Incidence and Mortality of Hospital-treated Sepsis. Current Estimates and Limitations.

            Carolin Fleischmann, André Scherag, Neill K. J. Adhikari … (2016)
            Reducing the global burden of sepsis, a recognized global health challenge, requires comprehensive data on the incidence and mortality on a global scale.
            Article 0 comments Cited 837 times – based on 0 reviews     Review now
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              International study of the prevalence and outcomes of infection in intensive care units.

              Jean-Louis Vincent (2009)
              Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. However, relatively little information is available about the global epidemiology of such infections. To provide an up-to-date, international picture of the extent and patterns of infection in ICUs. The Extended Prevalence of Infection in Intensive Care (EPIC II) study, a 1-day, prospective, point prevalence study with follow-up conducted on May 8, 2007. Demographic, physiological, bacteriological, therapeutic, and outcome data were collected for 14,414 patients in 1265 participating ICUs from 75 countries on the study day. Analyses focused on the data from the 13,796 adult (>18 years) patients. On the day of the study, 7087 of 13,796 patients (51%) were considered infected; 9084 (71%) were receiving antibiotics. The infection was of respiratory origin in 4503 (64%), and microbiological culture results were positive in 4947 (70%) of the infected patients; 62% of the positive isolates were gram-negative organisms, 47% were gram-positive, and 19% were fungi. Patients who had longer ICU stays prior to the study day had higher rates of infection, especially infections due to resistant staphylococci, Acinetobacter, Pseudomonas species, and Candida species. The ICU mortality rate of infected patients was more than twice that of noninfected patients (25% [1688/6659] vs 11% [ 682/6352], respectively; P < .001), as was the hospital mortality rate (33% [2201/6659] vs 15% [ 942/6352], respectively; P < .001) (adjusted odds ratio for risk of hospital mortality, 1.51; 95% confidence interval, 1.36-1.68; P < .001). Infections are common in patients in contemporary ICUs, and risk of infection increases with duration of ICU stay. In this large cohort, infection was independently associated with an increased risk of hospital death.
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                Author and article information

                Contributors
                Shuiqiao Fu: 2200048@zju.edu.cn
                Wenqiao Yu: yuwenqiao1980@zju.edu.cn
                Qinghui Fu: 2513107@zju.edu.cn
                Zhipeng Xu: doctorxzp@163.com
                Shaoyang Zhang: foothols2005@zju.edu.cn
                Ting-bo Liang: liangtingbo@zju.edu.cn
                Journal
                Journal ID (nlm-ta): BMC Surg
                Journal ID (iso-abbrev): BMC Surg
                Title: BMC Surgery
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2482
                Publication date (Electronic): 12 September 2023
                Publication date PMC-release: 12 September 2023
                Publication date Collection: 2023
                Volume: 23
                Electronic Location Identifier: 274
                Affiliations
                [1 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, The Department of SICU, The First Affiliated Hospital, , Zhejiang University School of Medicine, ; Qingchun street 79th, Hangzhou, 310003 Zhejiang Province China
                [2 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, The Department of Emergency, The First Affiliated Hospital, , Zhejiang University School of Medicine, ; Qingchun street 79th, Hangzhou, 310003 Zhejiang Province China
                [3 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, The Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, , Zhejiang University School of Medicine, ; Qingchun street 79th, Hangzhou, 310003 Zhejiang Province China
                Article
                Publisher ID: 2165
                DOI: 10.1186/s12893-023-02165-6
                PMC ID: 10498602
                PubMed ID: 37700315
                SO-VID: 7acf3934-9416-4d83-a2e9-6684bcc1cd40
                Copyright © © BioMed Central Ltd., part of Springer Nature 2023
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 27 January 2022
                Date accepted : 22 August 2023
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © BioMed Central Ltd., part of Springer Nature 2023

                ScienceOpen disciplines: Surgery
                Keywords: septic shock,acute enteric perforation,activated partial thromboplastin time,creatinine,fibrinogen
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: septic shock, acute enteric perforation, activated partial thromboplastin time, creatinine, fibrinogen

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