Elderly patients suffering from acute pathology and severe medical comorbidities present serious "mix-cases" and their multiple organ deterioration requires intensive care.
Goal of the study: analysis of outcome of elderly patients, aged 65 years and over, suffering from acute abdominal surgical pathology associated with hypovolemic shock.
Materials and methods: 2 244 patients aged 65 yrs and over were treated with an acute abdomen state in the 2nd Chair and Department of Surgery in Jagiellonian University Hospital within 01.07.1997 and 30.06.2004. 618 patients, aged > 65 yrs underwent surgery because of acute abdominal pathology with hypovolemic shock. Out of this group 239 cases presented peritoneal diffuse inflammation and 104 were diagnosed with bowel obstruction. The principles of the diagnosis and the therapy were common for both groups. The analysis included: mortality rate, duration of hospital and intensive care unit (ICU) stay, continuos assessment based on APACHE II (Acute Physiology And Chronic Health Evaluation) and TISS-28 (Therapeutic Intervention Scoring System) scales, and on modification of MODS (Multiple Organ Dysfuction Score) system.
Results: mortality rate patients with peritoneal diffuse inflammation was 51.05%, and was higher than patients with bowel obstruction 48.08%. The difference in these values was caused by infection by pathogenic bacteria of gastrointestinal tract and most frequently by the appearance of multiorgan dysfunction in the group with peritoneal diffuse inflammation, despite lower punctation in the APACHE II and TISS-28 score system.