title: Prediction of mortality in patients with colorectal perforation based on routinely available parameters: a retrospective study.
abstract: BACKGROUND
  Even after surgery and intensive postoperative management, the mortality rate associated with colorectal perforation is high. Identification of mortality markers using routinely available preoperative parameters is important.
  
  
  METHODS
  We enrolled consecutive patients with colorectal perforation who underwent operations from January 2010 to January 2015. We divided them into a mortality and survivor group and compared clinical characteristics between the two groups. Additionally, we compared the mortality rate between different etiologies: malignant versus benign and diverticular versus nondiverticular. We used the χ (2) and Mann-Whitney U tests and a logistic regression model to identify factors associated with mortality.
  
  
  RESULTS
  We enrolled 108 patients, and 52 (48 %) were male. The mean age at surgery was 71 ± 13 years. The postoperative mortality rate was 12 % (13 patients). Multivariate logistic regression analysis showed that a high patient age (odds ratio [OR], 1.09; 95 % confidence interval [CI], 1.020-1.181) and low preoperative systolic blood pressure (OR, 0.98; 95 % CI, 0.953-0.999) were independent risk factors for mortality in patients with colorectal perforation. In the subgroup analysis, there was no significant difference between the malignant and benign group (11.8 % vs. 23.9 %, respectively; p = 0.970), while the diverticular group had a significantly lower mortality rate than the nondiverticular group (2.6 % vs. 17.1 %, respectively; p = 0.027).
  
  
  CONCLUSIONS
  Older patients and patients with low preoperative blood pressure had a high risk of mortality associated with colorectal perforation. For such patients, operations and postoperative management should be performed carefully.
authors.affiliation: Department of Surgery, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ogimachi, Kita-ku, Osaka, 530-8480 Japan.
authors.forename: Takehito
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kita
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Masui
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kinoshita
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sakamoto
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Okada
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Komori
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Miki
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Uryuhara
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hashida
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kaihara
authors.affiliation: Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuoku, Kobe 650-0047 Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Hosotani
keywords: Colorectal perforation; Mortality marker; Prognostic factor