Вісник проблем біології і медицини (Mar 2022)

POSSIBILITIES OF USING THE P-POSSUM SCALE IN ELDERLY AND SENILE PATIENTS WITH ACUTE CHOLECYSTITIS

  • Danyliuk M. B.,
  • Zavhorodniy S. M.,
  • Rylov A. I.,
  • Kubrak M. A.,
  • Tielushko Ya. V.,
  • Shchurov M. F.

DOI
https://doi.org/10.29254/2077-4214-2022-1-163-127-131
Journal volume & issue
no. 1
pp. 127 – 131

Abstract

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The main goal of our work was to assess the feasibility and effectiveness of using the P-POSSUM scale in elderly and senile patients with acute calculous cholecystitis. Evaluation of the scale’s effectiveness in elderly and senile patients with acute abdominal surgical pathology The results of examination and treatment of 170 elderly and senile patients with acute calculous cholecystitis were analyzed. According to the results of ROC analysis, it was determined that the peak value of the increased risk of postoperative complications and mortality occurs in patients with a score of ≥ 32, p=0,012, AUC=0,652. The sensitivity of this method is 74,8%, specificity 51,9%. Given the defined peak scale, these patients were divided into two groups: the first group included 120 (70,6%) patients with a total score of ≤ 32 points, the second group included 50 (29,4%) patients with a total of number of points ≥ 33. The duration of preoperative preparation in both groups was equivalent, in the first group 24,00 (8,25; 28,00), in the second group 24,00 (10,00; 48,00) hours, U=2771,50, p=0,4355. All patients in both groups were operated on urgently. The types of surgical interventions did not differ in both subgroups, but we noted that the duration of artificial lung ventilation in the first group was 96,84 (60,00; 90,00) minutes, in the second group 128,44 (60,00; 100,00) minutes, U=2571,50, p=0,0437. The need to stay in the intensive care unit and prolonged ventilation arose in 5 (4,2%) cases in the first group and in 12 (24,0%) in the second group, U=2405,00, p=0,0420. Analyzing the results of treatment in both groups, we found that the use of the P-POSSUM scale in patients with acute cholecystitis in the elderly and senile significantly confirms the prognosis of increasing the incidence of postoperative complications, in the first group was 12 (10,0%) patients, the second group – 18 (36,0%), U=2220,00, p=0,0077. In patients of the group with the sum of points ≥ 33, the length of stay in the hospital was significantly increased by 11,04 (8,00; 13,00) days, in the first group – 9,34 (7,00; 11,00) days, U=2355,00, p=0,028, and recorded fatalities – 2 (4,0%), U=4395,00, p=0,6828.

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