Scoring model for the diagnosis of colorectal perforation and its differentiation from gastroduodenal perforation.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-06-01 Epub Date: 2024-10-22 DOI:10.1007/s00595-024-02949-0

Toshimichi Kobayashi, Eiji Hidaka, Itsuki Koganezawa, Masashi Nakagawa, Kei Yokozuka, Shigeto Ochiai, Takahiro Gunji, Toru Sano, Yuji Kikuchi, Koichi Tomita, Masatoshi Shigoka, Satoshi Tabuchi, Naokazu Chiba, Shigeyuki Kawachi

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引用次数: 0

Abstract

Purpose: Distinguishing colorectal from gastroduodenal perforations is clinically important and challenging. We aimed to establish a scoring model based on objective findings (excluding computed tomography findings) for the diagnosis of colorectal perforation and its differentiation from gastroduodenal perforation.

Methods: Patients diagnosed with colorectal or gastroduodenal perforations between January 2014 and December 2021 were retrospectively studied. Univariate and multivariate analyses were performed to identify independent variables, and a scoring model was developed based on these variables.

Results: Among 131 eligible patients, 64 (48.9%) were in the colorectal group and 67 (51.1%) were in the gastroduodenal group. White blood cell count, C-reactive protein, and quick Sequential Organ Failure Assessment score were identified as independent clinical variables associated with the diagnosis of colorectal perforation, which differentiated colorectal perforation from gastroduodenal perforation, and were used to develop a new scoring model. The scores ranged from 0 to 5, with an area under the receiver operating characteristic curve of 0.846. The probabilities of colorectal perforation with scores of 0, 1.5, 2, 3, 3.5, and 5 were 3.2, 20, 55.6, 81.8, 73.9, and 82.4%, respectively.

Conclusion: The new scoring model may help in treatment selection and perioperative management of patients with gastrointestinal perforation.

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诊断结直肠穿孔及其与胃十二指肠穿孔鉴别的评分模型。

目的：区分结肠直肠穿孔和胃十二指肠穿孔在临床上非常重要，也极具挑战性。我们旨在建立一个基于客观检查结果（不包括计算机断层扫描结果）的评分模型，用于诊断结直肠穿孔及其与胃十二指肠穿孔的鉴别：方法：对2014年1月至2021年12月期间确诊为结直肠或胃十二指肠穿孔的患者进行回顾性研究。进行单变量和多变量分析以确定自变量，并根据这些变量建立评分模型：在131名符合条件的患者中，结直肠组有64人（48.9%），胃十二指肠组有67人（51.1%）。白细胞计数、C反应蛋白和快速器官功能衰竭评估评分被确定为与结直肠穿孔诊断相关的独立临床变量，可将结直肠穿孔与胃十二指肠穿孔区分开来，并被用于建立新的评分模型。评分范围从 0 到 5，接收者操作特征曲线下面积为 0.846。0、1.5、2、3、3.5 和 5 分的结直肠穿孔概率分别为 3.2%、20%、55.6%、81.8%、73.9% 和 82.4%：新的评分模型有助于胃肠道穿孔患者的治疗选择和围手术期管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.