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Coagulation disorder as a prognostic factor for patients with colorectal perforation

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Abstract

Background

Although sepsis after surgery for colorectal perforation frequently results in severe coagulation disorders and consequent death of the patient, the correlation between coagulation abnormalities and postoperative mortality of colorectal perforation has not been clarified.

Methods

The medical records of 101 consecutive patients receiving surgery for colorectal perforations between January 1994 and July 2006 were retrospectively reviewed. The abnormalities of preoperative laboratory data reflecting coagulation disorders and other possible risk factors were analyzed by univariate and multivariate analysis.

Results

Prolonged prothrombin time and activated partial thromboplastin time significantly correlated with a poor prognosis (both P < 0.001). Among the several risk factors analyzed, only the presence of coagulation disorders was an independent predictive factor of postoperative mortality.

Conclusions

Prolonged prothrombin time and activated partial thromboplastin time are useful prognostic factors for predicting the surgical outcome for patients with colorectal perforation.

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References

  1. S Kriwanek C Armbruster P Beckerhinn K Dittrich (1994) ArticleTitlePrognostic factors for survival in colonic perforation Int J Colorectal Dis 9 158–62 Occurrence Handle7814991 Occurrence Handle10.1007/BF00290194 Occurrence Handle1:STN:280:DyaK2M7hsVGhsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  2. A Nespoli C Ravizzini M Trivella M Segala (1993) ArticleTitleThe choice of surgical procedure for peritonitis due to colonic perforation Arch Surg 128 814–8 Occurrence Handle8317964 Occurrence Handle1:STN:280:DyaK3szgsFSjuw%3D%3D

    PubMed  CAS  Google Scholar 

  3. RP Waldron IA Donovan (1986) ArticleTitleMortality in patients with obstructing colorectal cancer Ann R Coll Surg Engl 68 219–21 Occurrence Handle3789610 Occurrence Handle1:STN:280:DyaL2s%2FnsVGrsQ%3D%3D

    PubMed  CAS  Google Scholar 

  4. JW Dutton A Hreno LG Hampson (1976) ArticleTitleMortality and prognosis of obstructing carcinoma of the large bowel Am J Surg 131 36–41 Occurrence Handle1247151 Occurrence Handle10.1016/0002-9610(76)90417-7 Occurrence Handle1:STN:280:DyaE287gvFKnsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  5. ES Tyau JB Prystowsky RJ Joehl DL Nahrwold (1991) ArticleTitleAcute diverticulitis. A complicated problem in the immunocompromised patient Arch Surg 126 855–8 Occurrence Handle1854245 Occurrence Handle1:STN:280:DyaK3Mzgslerug%3D%3D

    PubMed  CAS  Google Scholar 

  6. T Ochiai S Hiranuma N Takiguchi K Ito A Kawaguchi T Iwai et al. (2004) ArticleTitleSOFA score predicts postoperative outcome of patients with colorectal perforation Hepatogastroenterology 51 1007–10 Occurrence Handle15239235

    PubMed  Google Scholar 

  7. S Komatsu T Shimomatsuya M Nakajima H Amaya T Kobuchi S Shiraishi et al. (2005) ArticleTitlePrognostic factors and scoring system for survival in colonic perforation Hepatogastroenterology 52 761–4 Occurrence Handle15966200

    PubMed  Google Scholar 

  8. K Bielecki P Kaminski M Klukowski (2002) ArticleTitleLarge bowel perforation: morbidity and mortality Tech Coloproctol 6 177–82 Occurrence Handle12525912 Occurrence Handle10.1007/s101510200039 Occurrence Handle1:STN:280:DC%2BD3s%2FhvFChsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  9. T Yilmazlar S Toker A Zorluoglu (1999) ArticleTitleNon-traumatic colorectal perforations Int Surg 84 155–8 Occurrence Handle10408288 Occurrence Handle1:STN:280:DyaK1MzjsVOksQ%3D%3D

    PubMed  CAS  Google Scholar 

  10. S Biondo E Ramos D Fraccalvieri E Kreisler JM Rague E Jaurrieta (2006) ArticleTitleComparative study of left colonic Peritonitis Severity Score and Mannheim Peritonitis Index Br J Surg 93 616–22 Occurrence Handle16607684 Occurrence Handle10.1002/bjs.5326 Occurrence Handle1:STN:280:DC%2BD283gvFCgtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  11. GT Kinasewitz JG Zein GL Lee SA Nazir FB Taylor SuffixJr (2005) ArticleTitlePrognostic value of a simple evolving disseminated intravascular coagulation score in patients with severe sepsis Crit Care Med 33 2214–21 Occurrence Handle16215373 Occurrence Handle10.1097/01.CCM.0000181296.53204.DE

    Article  PubMed  Google Scholar 

  12. H ten Cate (2000) ArticleTitlePathophysiology of disseminated intravascular coagulation in sepsis Crit Care Med 28 S9–11 Occurrence Handle11007190 Occurrence Handle10.1097/00003246-200009001-00003 Occurrence Handle1:STN:280:DC%2BD3cvltFGjsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  13. S Kumar UC Ghoshal R Aggarwal VA Saraswat G Choudhuri (2004) ArticleTitleSevere ulcerative colitis: prospective study of parameters determining outcome J Gastroenterol Hepatol 19 1247–52 Occurrence Handle15482530 Occurrence Handle10.1111/j.1440-1746.2004.03486.x

    Article  PubMed  Google Scholar 

  14. K Maeda M Hirota A Ichihara M Ohmuraya D Hashimoto H Sugita et al. (2006) ArticleTitleApplicability of disseminated intravascular coagulation parameters in the assessment of the severity of acute pancreatitis Pancreas 32 87–92 Occurrence Handle16340749 Occurrence Handle10.1097/01.mpa.0000186248.89081.44

    Article  PubMed  Google Scholar 

  15. EJ Hinchey PG Schaal GK Richards (1978) ArticleTitleTreatment of perforated diverticular disease of the colon Adv Surg 12 85–109 Occurrence Handle735943 Occurrence Handle1:STN:280:DyaE1M7gtVygtw%3D%3D

    PubMed  CAS  Google Scholar 

  16. MM Linder H Wacha U Feldmann G Wesch RA Streifensand E Gundlach (1987) ArticleTitleThe Mannheim peritonitis index. An instrument for the intraoperative prognosis of peritonitis (in German) Chirurg 58 84–92 Occurrence Handle3568820 Occurrence Handle1:STN:280:DyaL2s7ovFeiug%3D%3D

    PubMed  CAS  Google Scholar 

  17. DA Triplett (2000) ArticleTitleCoagulation and bleeding disorders: review and update Clin Chem 46 1260–9 Occurrence Handle10926920 Occurrence Handle1:CAS:528:DC%2BD3cXlvFWktbc%3D

    PubMed  CAS  Google Scholar 

  18. PG Carraro M Segala C Orlotti G Tiberio (1998) ArticleTitleOutcome of large-bowel perforation in patients with colorectal cancer Dis Colon Rectum 41 1421–6 Occurrence Handle9823810 Occurrence Handle10.1007/BF02237060 Occurrence Handle1:STN:280:DyaK1M%2FjvFCitA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  19. S Khan SE Pawlak JC Eggenberger CS Lee EJ Szilagy DA Margolin (2001) ArticleTitleAcute colonic perforation associated with colorectal cancer Am Surg 67 261–4 Occurrence Handle11270886 Occurrence Handle1:STN:280:DC%2BD3M7nsFOrsw%3D%3D

    PubMed  CAS  Google Scholar 

  20. M Levi E de Jonge T van der Poll (2003) ArticleTitleSepsis and disseminated intravascular coagulation J Thromb Thrombolysis 16 43–7 Occurrence Handle14760211 Occurrence Handle10.1023/B:THRO.0000014592.27892.11 Occurrence Handle1:CAS:528:DC%2BD2cXovVCquw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  21. CE Dempfle (2004) ArticleTitleCoagulopathy of sepsis Thromb Haemost 91 213–24 Occurrence Handle14961146 Occurrence Handle1:CAS:528:DC%2BD2cXhs1SqtLg%3D

    PubMed  CAS  Google Scholar 

  22. FB Taylor SuffixJr CH Toh WK Hoots H Wada M Levi (2001) ArticleTitleTowards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation Thromb Haemost 86 1327–30 Occurrence Handle11816725 Occurrence Handle1:CAS:528:DC%2BD3MXosFyhsbo%3D

    PubMed  CAS  Google Scholar 

  23. CK Hui KC Lai MF Yuen M Ng CL Lai SK Lam (2001) ArticleTitleAcute cholangitis—predictive factors for emergency ERCP Aliment Pharmacol Ther 15 1633–7 Occurrence Handle11564004 Occurrence Handle10.1046/j.1365-2036.2001.01071.x Occurrence Handle1:STN:280:DC%2BD3MrhslSktw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  24. AD Maslow TW Breen MC Sarna AK Soni J Watkins NE Oriol (1996) ArticleTitlePrevalence of coagulation abnormalities associated with intrauterine fetal death Can J Anaesth 43 1237–43 Occurrence Handle8955974 Occurrence Handle1:STN:280:DyaK2s7hsVWksQ%3D%3D Occurrence Handle10.1007/BF03013432

    Article  PubMed  CAS  Google Scholar 

  25. JL Vincent A de Mendonca F Cantraine R Moreno J Takala PM Suter et al. (1998) ArticleTitleUse of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine Crit Care Med 26 1793–800 Occurrence Handle9824069 Occurrence Handle1:STN:280:DyaK1M%2FjvFKktw%3D%3D

    PubMed  CAS  Google Scholar 

  26. Hambleton J, Leung LL, Levi M. Coagulation: consultative hemostasis. Hematology Am Soc Hematol Educ Program 2002:335–52

  27. J Makela H Kiviniemi S Laitinen (2002) ArticleTitlePrevalence of perforated sigmoid diverticulitis is increasing Dis Colon Rectum 45 955–61 Occurrence Handle12130886 Occurrence Handle10.1007/s10350-004-6335-5

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Yaizu City Hospital, 1000 Dobara, Yaizu, 425-8505, Japan

    Kazushige Kawai, Takeyuki Hiramatsu, Ryo Kobayashi, Naoki Takabayashi, Yukio Ishihara, Ko Ohata, Hirotaka Niwa, Junji Yasuike, Hiroki Tanaka, Mitsutoshi Kimura & Junichi Shindoh

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  1. Kazushige Kawai
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  2. Takeyuki Hiramatsu
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  3. Ryo Kobayashi
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  4. Naoki Takabayashi
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  5. Yukio Ishihara
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  7. Hirotaka Niwa
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  11. Junichi Shindoh
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Kawai, K., Hiramatsu, T., Kobayashi, R. et al. Coagulation disorder as a prognostic factor for patients with colorectal perforation. J Gastroenterol 42, 450–455 (2007). https://doi.org/10.1007/s00535-007-2027-y

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  • DOI: https://doi.org/10.1007/s00535-007-2027-y

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