PROGNOSIS OF ABDOMINAL SEPSIS

Summary. Introduction. As is known, sepsis is among the top ten leading causes of death in the world, and the mortality rate in sepsis is high and remains at 9-32%. According to modern concepts, sepsis is an excessive and life-threatening reaction of the body to infection, which leads to disruption of many organ systems and is characterized by multiple organ failure. The aim of the study. The aim of the research is to assess the prognostic and diagnostic value of various clinical and laboratory parameters in order to substantiate a prognostic complex for patients with abdominal sepsis (AS). Materials and methods. The study involved 183 patients with acute peritonitis and a clinical picture of systemic inflammatory response syndrome and AS with mean age of (53.27±6.49) years. Upon admission, all patients were assessed for organ dysfunction using the qSOFA score, as well as a number of clinical and laboratory markers according to recommendations from literature. Results. For the age value over 80 years, the risk ratio (RR) value was 4 (95% CI, 3-5, P<0.01), for the immunodeficiency – 3 (95% CI, 2-4, P<0.01), for malignant neoplasms – 3 (95% CI, 3-4, P<0.01), for cardiovascular failure – 4 (95% CI, 3-5, P<0.01), for diabetes mellitus – 2 (95% CI, 2-3, P<0.01), for chronic kidney disease – 5 (95% CI, 4-6, P<0.01), for COPD – 4 (95% CI, 3-6, P<0.01). All clinical markers, except for an elevated temperature >38.0° C, showed a high level of prognostic value. For the qSOFA scale indicators, 2 points received a RR value of 3 (CI 95%, 3-4, P<0.001) and for qSOFA 3 points – 7 (CI 95%, 6-9, P<0.001), respectively. Conclusions. Timely prediction of abdominal sepsis is complex and should include the assessment of many clinical parameters. All studied indicators, with the exception of temperature increase above 38.0° C, have reliable prognostic value and can be used in the prediction of abdominal sepsis, the qSOFA scale with a value of 2-3 points is a reliable predictor of the development of sepsis, too.