Extra-abdominal CT imaging indicates increased severity of illness in advanced age patients requiring emergency abdominal surgery

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-03-12 DOI:10.1016/j.amjsurg.2025.116297

Lavina Malhotra , Andrew H. Stephen , Madeline Goosman , Adam R. Aluisio , Mohammed Arafeh , Charles A. Adams , Stephanie N. Leuckel , Brent Emigh , Benjamin M. Hall , Daithi S. Heffernan

{"title":"Extra-abdominal CT imaging indicates increased severity of illness in advanced age patients requiring emergency abdominal surgery","authors":"Lavina Malhotra , Andrew H. Stephen , Madeline Goosman , Adam R. Aluisio , Mohammed Arafeh , Charles A. Adams , Stephanie N. Leuckel , Brent Emigh , Benjamin M. Hall , Daithi S. Heffernan","doi":"10.1016/j.amjsurg.2025.116297","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Abdominal sepsis frequently causes neurologic and pulmonary dysfunction among geriatric patients, We hypothesize that patients with abdominal sepsis who undergo extra-abdominal imaging have a greater burden of illness.</div></div><div><h3>Methods</h3><div>Patients 65 years and older that underwent emergency abdominal surgery for sepsis were divided into those with abdominal only(AbdCT) versus abdominal and extra-abdominal(ExtraCT) imaging.</div></div><div><h3>Results</h3><div>ExtraCT patients(N = 30) compared to AbdCT(N = 97) had higher rates of dementia(13.3 % versus 3.3 %; p = 0.03), diabetes(93.3 % versus 60.1 %; p < 0.01 and COPD(70 % versus 29.9 %; p < 0.01) but lower rates of abdominal pain as chief complaint (23.3 % versus 81.4 %; p < 0.01) and higher rates of being qSOFA positive (33.3 % vs 7.2 %; p < 0.05). Importantly, time to OR was not different between groups. ExtraCT patients had higher rates of 30-day mortality (33.3 % vs 5.2 %; p < 0.01). Extra-abdominal CT imaging was associated with increased risk of mortality (OR = 5.4; 95 %CI = 1.4–20.1).</div></div><div><h3>Conclusions</h3><div>ExtraCT among geriatric patients with abdominal emergencies is a marker of severity of illness and should guide end-of-life decision making.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"244 ","pages":"Article 116297"},"PeriodicalIF":2.7000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0002961025001199","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Abdominal sepsis frequently causes neurologic and pulmonary dysfunction among geriatric patients, We hypothesize that patients with abdominal sepsis who undergo extra-abdominal imaging have a greater burden of illness.

Methods

Patients 65 years and older that underwent emergency abdominal surgery for sepsis were divided into those with abdominal only(AbdCT) versus abdominal and extra-abdominal(ExtraCT) imaging.

Results

ExtraCT patients(N = 30) compared to AbdCT(N = 97) had higher rates of dementia(13.3 % versus 3.3 %; p = 0.03), diabetes(93.3 % versus 60.1 %; p < 0.01 and COPD(70 % versus 29.9 %; p < 0.01) but lower rates of abdominal pain as chief complaint (23.3 % versus 81.4 %; p < 0.01) and higher rates of being qSOFA positive (33.3 % vs 7.2 %; p < 0.05). Importantly, time to OR was not different between groups. ExtraCT patients had higher rates of 30-day mortality (33.3 % vs 5.2 %; p < 0.01). Extra-abdominal CT imaging was associated with increased risk of mortality (OR = 5.4; 95 %CI = 1.4–20.1).

Conclusions

ExtraCT among geriatric patients with abdominal emergencies is a marker of severity of illness and should guide end-of-life decision making.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.