• Tadashi Matsuoka, Ryo Yamamoto, Kazuki Matsumura, Rie Kondo, Kenji Kobayashi, Alan Kawarai Lefor, Junichi Sasaki, and Hiroharu Shinozaki.
• Department of Surgery, Saiseikai Utsunomiya Hospital, 911-1 Takebayashi-cho, Utsunomiya, Tochigi, 321-0974, Japan. tadashi_matsuoka1984@yahoo.co.jp.
• Eur J Trauma Emerg Surg. 2022 Aug 1; 48 (4): 3017-3024.

PurposeAlthough early prediction of mortality is useful for the management of patients with colorectal perforations, no significant perioperative predictive factors have been identified. The purpose of this study was to identify useful prognostic factors for patients with colorectal perforation.MethodsThis single-center retrospective study included consecutive patients undergoing emergency surgery for colorectal perforation from January 2012 to December 2019. The primary outcome was combined 30 day and in-hospital mortality. Patient- and disease-related factors obtained perioperatively were evaluated for mortality prediction. A scoring system was developed to enhance clinical utility.ResultsOverall, 146 patients were included and 20 (14%) died after surgery. Multivariate logistic regression identified five predictive factors: age, hemodialysis, uncommon perforation etiology, plasma albumin level, and decreased platelet count. The area under the receiver operating curve for the scoring system using these parameters was 0.894 (95% CI 0.835-0.952). Patients at high-risk of mortality were classified by the proposed score with a sensitivity of 90.0% and negative predictive value of 98.0%.ConclusionThis study identified five perioperative factors significantly associated with mortality of patients with colorectal perforation. Although these parameters predict mortality of patients with colorectal perforation using a score with high discrimination, further study is required to confirm these findings.© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.

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