The clinical evaluation of sepsis-1 and sepsis-3 in patients with acute surgical abdominal pathology

Abstract

Purpose of the study. Comparison Sepsis-1 and Sepsis-3 use in clinical practice at patients with acute surgical abdominal pathology. Materials and methods. The treatment results of 3302 patients with acute surgical abdominal pathology, which were operated at the clinic of the Chair of surgery and endoscopy at Lviv Danylo Halytskyi national medical university in 2008–2018 are analysed. In 272 (8,2%) cases there were signs of abdominal sepsis (AS). Gram-negative flora (E. coli in 198 (72,8%) of patients) was the most common cause of infection. We evaluated clinical and laboratory characteristics, which are used for stratification of patients according to classifications Sepsis-1 and Sepsis-3. Results. Patients were stratified using Sepsis-1, of which 227 (83,5%) were diagnosed using Sepsis-3 (SOFA г 2). Mortality among patients with Sepsis-1 was 41,2% (112/272), among those with Sepsis-3 – 45,4% (103/227). Using Sepsis-3, 45 (16,5%) patients were excluded; values of APACHE II and SOFA, as well as length of stay in these patients was significantly lower; no deaths occurred. Therefore, diagnostic criteria of Sepsis-3 significantly reduce the number of patients with acute surgical abdominal pathology, complicated AS, compared with Sepsis-1. Diagnostic value of various factors that allow early detection of sepsis in the absence of an ideal standard is important. Conclusion. Indicators of Sepsis-3 are informative in the diagnosis and staging of abdominal sepsis.

Keywords

• acute abdominal surgical pathology
• abdominal sepsis
• sepsis-1
• sepsis-3
• mortality