کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3943241 1254087 2009 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Survival after intestinal perforation: Can it be predicted?
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی زنان، زایمان و بهداشت زنان
پیش نمایش صفحه اول مقاله
Survival after intestinal perforation: Can it be predicted?
چکیده انگلیسی

ObjectiveIntestinal perforation is associated with high morbidity and mortality in gynecologic oncology patients. We investigated potential factors associated with survival after perforation which may influence treatment recommendations.MethodsA retrospective review of all gynecologic oncology patients experiencing intestinal perforation between 1993 and 2007 was performed. Demographics, cancer history, presenting symptoms, vital signs, laboratory values, and management of perforation were collected, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were calculated for each patient. Factors affecting survival from the time of perforation were analyzed using Kaplan–Meier method and univariate and multivariate Cox proportional hazard models. Student's t-test and χ2 analysis were also utilized to evaluate potential associations.ResultsFifty-three patients met the inclusion criteria. No difference in survival was found based on disease site, history of radiation therapy, presenting symptoms, smoking history, or presence of bowel procedures performed during the most recent abdominal surgery prior to perforation. APACHE II score, disease status, body mass index, and treatment method of perforation were found to be significant prognostic factors for survival. After multivariate Cox regression analysis, only APACHE II scores remained significantly associated with an increased risk of death. Median survival of patients with APACHE II scores < 15 was 28.13 months compared to 2.90 months in patients with scores ≥ 15 (P < 0.0001).ConclusionMany factors must be examined when determining the management of intestinal perforation in gynecologic oncology patients. Clinicians should consider the APACHE II score in their assessment to assist risk stratification and treatment planning of these patients.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Gynecologic Oncology - Volume 115, Issue 3, December 2009, Pages 349–353
نویسندگان
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