Prognostic role of comorbid status in estimation of surgical treatment results in patients with perforated ulcer

Abstract

INTRODUCTION. The heterogeneity of the population of patients with perforated ulcers determines the need for a targeted research of the results of their treatment, including taking into account the level of comorbidity.OBJECTIVE. To study the results and develop a predictive model of surgical treatment of perforated ulcers, taking into account the comorbid status of patients.METHODS AND MATERIALS. The results of treatment of 194 patients with perforated ulcers of the stomach and duodenum were studied. Stratification of patients was carried out taking into account the Charlson-Deyo comorbidity index. The construction of prognostic models was carried out using binary logistic regression.RESULTS. Depending on the level of comorbidity, during a posteriori comparisons, the incidence of postoperative complications in the third group (46.7%, 28/60) was statistically significantly higher compared to the first (22.8%, 13/57) and second groups (16.9%, 13/77) (χ2 = 15.908, p<0.001).In a comparative analysis, a prognostic model taking into account the comorbid status of the patient predicted the development of postoperative complications and mortality with the greatest accuracy.CONCLUSION. Taking into account the comorbid status of patients with perforated ulcer makes it possible to predict with greater accuracy the development of postoperative complications of III-V degree according to Clavien-Dindo.