Clinical characteristics of lower bowel perforation with chronic renal failure.
OBJECTIVE
This study was conducted to evaluate the clinical characteristics of lower bowel perforation (LBP) with chronic renal failure (CRF).


METHODS
In 58 patients with LBP, clinical variables, such as findings of clinical examinations, operative findings, and results of laboratory blood tests were examined as possible prognostic factors for in-hospital death, and compared between CRF and non-CRF groups.


RESULTS
Of the 58 patients, 21 died during hospitalization (mortality rate, 36.2%). The mortality rate of patients with CRF was 54.2%. In the patients with LBP, the following variables were significantly correlated with in-hospital death (p<0.05): hypotension, CRF, fecal peritonitis, and low white blood cell (WBC) count, and low albumin and base excess (BE) levels. The odds ratios of in-hospital death were highest for a WBC count of 9000/mm3 and a BE of -3mEqL. Between the CRF and non-CRF groups, significant differences in the rates of age < 70 years, fecal peritonitis, in-hospital death, and low WBC count and BE were found (p<0.05).


CONCLUSIONS
We identified prognostic factors of LBP and demonstrated the clinical characteristics of LBP with CRF. These results indicate that patients who have LBP with CRF tend to have immediate sepsis and a poor prognosis.
Masuda
Taka-aki
TA
Department of Gastroenterological Surgery, National Kyushu Cancer Center, 3-1-1, Notame, Minami-ku, Fukuoka 811-1395, Japan. takaakimas@ybb.ne.jp
Iso
Yasunori
Y
Funahashi
Satoru
S
Tateishi
Masahiro
M
Shima
Ichiro
I
Kido
Akinori
A
Gohya
Tadanobu
T
Masuda
Hidetaka
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000401:mortality*; D007676:Kidney Failure, Chronic / Q000150:complications*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies