Chen RX, Wu ZQ, Li ZY, Wang HZ, Ji JF. Prognostic predictors in patients with sepsis after gastrointestinal tumor surgery: A retrospective study. World J Gastrointest Surg 2021; 13(3): 256-266 [PMID: 33796214 DOI: 10.4240/wjgs.v13.i3.256]
Corresponding Author of This Article
Hong-Zhi Wang, MD, Professor, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU Department, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. wanghz58@sina.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Mar 27, 2021; 13(3): 256-266 Published online Mar 27, 2021. doi: 10.4240/wjgs.v13.i3.256
Prognostic predictors in patients with sepsis after gastrointestinal tumor surgery: A retrospective study
Ren-Xiong Chen, Zhou-Qiao Wu, Zi-Yu Li, Hong-Zhi Wang, Jia-Fu Ji
Ren-Xiong Chen, Hong-Zhi Wang, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU Department, Peking University Cancer Hospital and Institute, Beijing 100142, China
Zhou-Qiao Wu, Zi-Yu Li, Jia-Fu Ji, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Chen RX, Wang HZ, and Ji JF contributed to the design of this study; Chen RX, Wu ZQ, and Li ZY collected the clinical data; Chen RX and Ji JF contributed to data analysis; Chen RX and Wang HZ performed the statistical analysis; all the authors participated in drafting the manuscript; Wang HZ and Ji JF revised the manuscript; Wang HZ and Ji JF are the co-corresponding authors; all the authors approved the final version of the manuscript.
Institutional review board statement: This study was approved by Medical Ethical Committee of Peking University Cancer Hospital.
Informed consent statement: All ICU patients or their next of kin were given information that their data was stored in our registry for quality control and research purposes and the option to have their data deleted.
Conflict-of-interest statement: All the authors declare that there are no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Zhi Wang, MD, Professor, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU Department, Peking University Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. wanghz58@sina.com
Received: November 3, 2020 Peer-review started: November 3, 2020 First decision: December 20, 2020 Revised: December 23, 2020 Accepted: January 28, 2021 Article in press: January 28, 2021 Published online: March 27, 2021 Processing time: 134 Days and 23.2 Hours
ARTICLE HIGHLIGHTS
Research background
There have been different reports on mortality of sepsis, but few focus on the prognosis of patients with sepsis after surgery.
Research motivation
To explore the prognostic predictors in patients with sepsis after gastrointestinal tumor surgery.
Research objectives
We studied the clinical features and prognostic predictors in patients with sepsis after gastrointestinal tumor surgery in intensive care unit (ICU).
Research methods
We retrospectively screened patients who underwent gastrointestinal tumor surgery at Peking University Cancer Hospital from January 2015 to December 2019. Among them, 181 patients who were diagnosed with sepsis in ICU were included in our study. Survival was analysed by the Kaplan-Meier method. Univariate and multivariate adjusted analyses were performed to identify predictors of prognosis.
Research results
The 90-d all-cause mortality rate was 11.1% in our study. In multiple analysis, we found that body mass index (BMI) ≤ 20 kg/m2, lactic acid after ICU admission, and sequential organ failure assessment (SOFA) score within 24 h after ICU admission might be independent risk predictors of the prognosis of sepsis after gastrointestinal tumor surgery. Compared with SOFA score, SOFA score combined with BMI and lactic acid might have higher predictive ability (area under the receiver operating characteristic curve, 0.859; 95% confidence interval, 0.789-0.929).
Research conclusions
Lactic acid and SOFA score within 24 h after ICU admission are independent risk predictors of the prognosis of sepsis after gastrointestinal tumor surgery. SOFA score combined with BMI and lactic acid might have good predictive value.
Research perspectives
More large-scale studies are needed in the future to confirm these results.
