title: Surgical treatment of acute abdominal complications in hematology patients: outcomes and prognostic factors.
abstract: The decision to operate on hematology patients with abdominal emergencies can be difficult, as neutropenia and thrombocytopenia are common and the usual causes of abdominal pain are broad. We conducted a retrospective observational study including all hematology patients undergoing emergency abdominal surgery between January 1998 and January 2013. Of the fifty-eight consecutive patients included in the study, nineteen (33%) underwent an operation during the neutropenia period. In the multivariate analysis, a laparotomy after 2002 was protective (HR: 0.05; 95%CI: 0.001-0.24), whereas preoperative septic shock (HR: 8.58; 95%CI: 2.25-32.63) and use of dialysis (HR: 6.67; 95%CI: 2.11-21.07) were independently associated with hospital mortality. Surgery during neutropenia or thrombocytopenia was not associated with prognosis. In hematology patients, emergency abdominal surgery is associated with encouraging hospital survival rates. Surgery should be performed prior to septic shock, regardless of whether neutropenia or thrombocytopenia is present.
authors.affiliation: a Réanimation Polyvalente et Département d'Anesthésie et de Réanimation , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Djamel
authors.initials: D
authors.lastname: Mokart
authors.affiliation: a Réanimation Polyvalente et Département d'Anesthésie et de Réanimation , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Marion
authors.initials: M
authors.lastname: Penalver
authors.affiliation: a Réanimation Polyvalente et Département d'Anesthésie et de Réanimation , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Chow-Chine
authors.affiliation: b Département de Chirurgie Oncologique , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Ewald
authors.affiliation: a Réanimation Polyvalente et Département d'Anesthésie et de Réanimation , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Sannini
authors.affiliation: a Réanimation Polyvalente et Département d'Anesthésie et de Réanimation , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Brun
authors.affiliation: a Réanimation Polyvalente et Département d'Anesthésie et de Réanimation , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Magali
authors.initials: M
authors.lastname: Bisbal
authors.affiliation: b Département de Chirurgie Oncologique , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Lelong
authors.affiliation: b Département de Chirurgie Oncologique , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Jean Robert
authors.initials: JR
authors.lastname: Delpero
authors.affiliation: a Réanimation Polyvalente et Département d'Anesthésie et de Réanimation , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Marion
authors.initials: M
authors.lastname: Faucher
authors.affiliation: b Département de Chirurgie Oncologique , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Turrini
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D004630:Emergencies; D019337:Hematologic Neoplasms / Q000150:complications; D017052:Hospital Mortality; D006801:Humans; D009503:Neutropenia / Q000150:complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012772:Shock, Septic / Q000209:etiology; D015996:Survival Rate; D013921:Thrombocytopenia / Q000150:complications
keywords: Emergency abdominal surgery; hematology patients; neutropenia; prognosis; septic shock