Prognostic Factors of Perforated Sigmoid Diverticulitis in the Elderly
Background: The Finnish population is aging fast and the prevalence of perforated sigmoid diverticulitis is simultaneously increasing in northern Finland. The fact that an increasing number of elderly patients, with their age-specific problems, are subjected to emergency surgery for acute diverticul...
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crskarger:10.1159/000085472 2024-06-16T07:42:10+00:00 Prognostic Factors of Perforated Sigmoid Diverticulitis in the Elderly Mäkelä, Jyrki Tapani Kiviniemi, Heikki Laitinen, Seppo 2005 http://dx.doi.org/10.1159/000085472 https://www.karger.com/Article/Pdf/85472 en eng S. Karger AG https://www.karger.com/Services/SiteLicenses https://www.karger.com/Services/SiteLicenses Digestive Surgery volume 22, issue 1-2, page 100-106 ISSN 0253-4886 1421-9883 journal-article 2005 crskarger https://doi.org/10.1159/000085472 2024-05-22T12:59:27Z Background: The Finnish population is aging fast and the prevalence of perforated sigmoid diverticulitis is simultaneously increasing in northern Finland. The fact that an increasing number of elderly patients, with their age-specific problems, are subjected to emergency surgery for acute diverticulitis underlines the importance of risk stratification. Methods: One hundred and seventy-two patients admitted to Oulu University Hospital because of diverticular perforation from 1983 to 2002 were identified from the computer database. The clinical variables were evaluated as prognostic indicators of postoperative complications, mortality and time of hospitalization. Results: The resection rate was 91%; 64 primary anastomoses, 93 Hartmann’s procedures and two covering colostomies were performed. The overall complication rate was 33%. In patients under 70 years, a stepwise logistic regression analysis showed that the Mannheim Peritonitis Index (MPI) score and American Society of Anesthesiologists (ASA) score were independent prognostic factors. None of factors predicted morbidity in patients over 70 years. Overall mortality rate was 8%, without any significant difference between the procedures. Of the clinical variables, MPI score, ASA score, Hinchey classes and malnutrition correlated with mortality. All patients who died presented with ASA scores of III–IV, and 12 out of 14 patients had an MPI score of II. In a stepwise logistic regression analysis, only the MPI score seemed to be an independent predictor of mortality. Conclusions: Mortality is related to age but age alone is not an independent predictor of mortality. The MPI score is useful in predicting the risk of death in patients with perforated diverticulitis. Article in Journal/Newspaper Northern Finland Karger Digestive Surgery 22 1-2 100 106 |
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Background: The Finnish population is aging fast and the prevalence of perforated sigmoid diverticulitis is simultaneously increasing in northern Finland. The fact that an increasing number of elderly patients, with their age-specific problems, are subjected to emergency surgery for acute diverticulitis underlines the importance of risk stratification. Methods: One hundred and seventy-two patients admitted to Oulu University Hospital because of diverticular perforation from 1983 to 2002 were identified from the computer database. The clinical variables were evaluated as prognostic indicators of postoperative complications, mortality and time of hospitalization. Results: The resection rate was 91%; 64 primary anastomoses, 93 Hartmann’s procedures and two covering colostomies were performed. The overall complication rate was 33%. In patients under 70 years, a stepwise logistic regression analysis showed that the Mannheim Peritonitis Index (MPI) score and American Society of Anesthesiologists (ASA) score were independent prognostic factors. None of factors predicted morbidity in patients over 70 years. Overall mortality rate was 8%, without any significant difference between the procedures. Of the clinical variables, MPI score, ASA score, Hinchey classes and malnutrition correlated with mortality. All patients who died presented with ASA scores of III–IV, and 12 out of 14 patients had an MPI score of II. In a stepwise logistic regression analysis, only the MPI score seemed to be an independent predictor of mortality. Conclusions: Mortality is related to age but age alone is not an independent predictor of mortality. The MPI score is useful in predicting the risk of death in patients with perforated diverticulitis. |
format |
Article in Journal/Newspaper |
author |
Mäkelä, Jyrki Tapani Kiviniemi, Heikki Laitinen, Seppo |
spellingShingle |
Mäkelä, Jyrki Tapani Kiviniemi, Heikki Laitinen, Seppo Prognostic Factors of Perforated Sigmoid Diverticulitis in the Elderly |
author_facet |
Mäkelä, Jyrki Tapani Kiviniemi, Heikki Laitinen, Seppo |
author_sort |
Mäkelä, Jyrki Tapani |
title |
Prognostic Factors of Perforated Sigmoid Diverticulitis in the Elderly |
title_short |
Prognostic Factors of Perforated Sigmoid Diverticulitis in the Elderly |
title_full |
Prognostic Factors of Perforated Sigmoid Diverticulitis in the Elderly |
title_fullStr |
Prognostic Factors of Perforated Sigmoid Diverticulitis in the Elderly |
title_full_unstemmed |
Prognostic Factors of Perforated Sigmoid Diverticulitis in the Elderly |
title_sort |
prognostic factors of perforated sigmoid diverticulitis in the elderly |
publisher |
S. Karger AG |
publishDate |
2005 |
url |
http://dx.doi.org/10.1159/000085472 https://www.karger.com/Article/Pdf/85472 |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_source |
Digestive Surgery volume 22, issue 1-2, page 100-106 ISSN 0253-4886 1421-9883 |
op_rights |
https://www.karger.com/Services/SiteLicenses https://www.karger.com/Services/SiteLicenses |
op_doi |
https://doi.org/10.1159/000085472 |
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Digestive Surgery |
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22 |
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1-2 |
container_start_page |
100 |
op_container_end_page |
106 |
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1802009554878201856 |