OBJECTIVE

To establish the features of postoperative period in late stages of acute abdominal diseases; to identify the informativeness of original method for prediction of postoperative period.

MATERIAL AND METHODS

There were 92 patients with acute surgical abdominal diseases including 57 (62.0%) patients with acute appendicitis complicated by peritonitis (the first group), 35 (38.0%) — acute intestinal obstruction complicated by peritonitis (the second group). In the first group, 31 (54.4%) patients admitted within 24 hours after manifestation (the first subgroup), 26 (45.6%) — after 24 hours (the second subgroup). In the second group, there were 20 (57.1%) and 15 (42.9%) similar patients, respectively. In early stages after surgery, we assessed some indicators of homeostasis, and some of them were used for prediction (patent No. 2729730).

RESULTS

The number of various early postoperative complications significantly correlated with duration of acute abdominal diseases. In patients of the second subgroups (admission after 24 hours), complications occur more often by 37.7% and 66.7%, respectively, compared to the first subgroups (admission before 24 hours) (more often by 41.6% and 57.4%, respectively, according to the Clavien-Dindo classification). Original method was highly effective in predicting the course of urgent abdominal diseases (sensitivity >91.2%, specificity >83.7%).

CONCLUSION

In delayed admission of patients, catabolic processes reach such values (sometimes thresholds) at which compensatory capabilities of the body are not able to fully compensate for them. This condition carried a real risk of postoperative complications. This fact is confirmed by high informativeness of original predictive method based on severity of membrane lesions.