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V.A. Suvorov, S.I. Panin, N.V. Kovalenko, M.P. Postolov, E.S. Mikhin, I.A. Peshkurova
Волгоградский государственный медицинский университет, Волгоград, Россия
Aim of the study. To assess the effect of perioperative factors on the duration of postoperative inpatient treatment of patients with perforated ulcers in conditions of different comorbidity. Material and methods. A study of the results of surgical treatment with a perforated ulcer was conducted in 194 patients. Group 1 included 57 patients (29 %) with a Charlson – Deyo comorbidity index of 0–2 points, group 2–77 patients (40 %) with a comorbidity index of 3–4 and group 3–60 patients (31 %). The Charlson – Deyo comorbidity index > 4 points. Paired and multiple linear regression were used to predict the duration of postoperative treatment. Results. The duration of the postoperative period in the first group was 9 [8–10] days, in the second group – 8 [7–9] days, in the third group – 10 [7–18] days (p < 0,001). Correlation between the level of comorbidity on the Charlson – Deyo scale straight, high closeness (ρ = 0,703), statistically significant (p < 0,001). In multivariate models for all levels of comorbidity, the significant regressor of the duration of postoperative inpatient treatment was the duration of surgery and the degree of complications according to Clavien – Dindo. In addition, in group 1, the factors were total blood bilirubin and perforation diameter, in group 3 – age, blood creatinine level and perforation diameter. Conclusion. Taking into account the comorbid status in the stratification of patients makes it possible to predict the duration of inpatient treatment of patients with perforated ulcers.
perforated ulcer, comorbidity, prognostic model, postoperative day
Владимир Александрович Суворов, oncologist.suvorov@gmail.com