ANALYSIS OF PROGNOSTIC VALUE OF LEUKOCYTE AND HEMATOLOGICAL INDEXES OF INTOXICATION IN THE DIAGNOSIS OF SURGICAL SEPSIS
Abstract
The mortality from surgical sepsis remains high and ranges from 17 to 83.7 %. The cause of high lethality is endogenous intoxication and multiple organ failure. The most common laboratory markers for determining the syndrome of endogenous intoxication in surgical sepsis are leukocyte and hematological intoxication indices, such as LII, HII, NII.
Aim of the work: to study the predictive value of laboratory and hematological indicators of intoxication in the diagnosis of surgical sepsis.
Materials and methods. A retrospective analysis of disease history and prospective follow-up of 41 patients treated for surgical sepsis in the Ivano-Frankivsk (Ukraine) Surgical Department of the CCCH in period between August 2015 and August 2018 was conducted. In the first day after the operation, all the patients been calculated the leukocyte index of intoxication, the hematological index of intoxication and the nuclear index of intoxication to assess their predictive and diagnostic significance. Methods of nonparametric statistics were used in the study: ROC-analysis, Mann-Whitney U-test, Spierman's criterion (Rs).
Results. The results of the diagnostic and prognostic significance of LII, HII, NII for 1 day postoperative period, with regard to the prediction of lethality by means of ROC analysis, Mann-Whitney U-test, Spirman criteria (Rs) showed low sensitivity and specificity in patients with surgical sepsis.
Common laboratory leukocyte and hematological non-specific indicators of endogenous intoxication determination have low prognostic and diagnostic significance in assessing the degree of endotoxicosis in surgical sepsis and can not serve as prognostic criteria for lethality.
Conclusions. The problem of diagnosing endotoxicosis in surgical sepsis requires the further study and introduction into clinical practice of new specific and integrated clinical and laboratory methods for the quantitative determination of endotoxicosis, which could serve as a reliable diagnostic criterion in assessing the severity of the condition and the prediction of hospital mortality.
Downloads
References
Matviichyk, B. O., Lukavetskyi, O. V., Fedorov, V. Yu. (2015). Limfopeniya yak predyktor letalnosti patsiyentiv iz abdominalnym sepsysom [Lymphopenia as the Predictor for Lethality of Patients with Abdominal Sepsis]. Shpytal’na Khirurhiya [Clinical Surgery], 1, 24–27.
Boontham, P., Chandran, P., Rowlands, B., Eremin, O. (2003). Surgical sepsis: dysregulation of immune function and therapeutic implications. The Surgeon, 1 (4), 187–206. doi: http://doi.org/10.1016/s1479-666x(03)80018-5
Selivanov, S. S., Bondaryev, R. V., Bondaryev, V. I., Fonova, N. O. (2011). Prohnoz tyazhkosti perebihu i naslidkiv hostroho rozlytoho perytonitu [Prognosis for the Severeness of the Course and Results of Acute Poured Peritonitis]. Ukrayinskyi Zhurnal Khirurhii [Ukrainian Surgery Journal], 3 (12), 62–65.
Neviere, R. (2009). Sepsis and the systemic inflammatory response syndrome: Detinitions, epidemiology and prognosis. Journal of Emergency Nursing, 35 (1), 47–54.
Borisov, D. B., Nadashkovskyi, E. V. (2005). Diahnosticheskaya znachimost’ nespetsyficheskikh markerov endotoksikoza pri rasprostranyonnom hnoinom peritonite [Diagnostic Value of Nonspecific Markers of Endotoxicosis in Extended Purulent Peritonitis]. Ekolohiya Cheloveka [Human Ecology], 6, 30–32.
Matviichuk, O. B., Matishunets, I. I., Melen, A. P. et al. (2010). Parametry endohennoyi intoksykatsii pry perytoniti [Parameters of Endogenic Intoxication in Peritonitis]. Ukrayinskyi Zhurnal Khirurhii [Ukrainian Surgery Journal], 2, 143–145.
Honchar, M. H., Kuchirka, Ya. M. (2011). Suchasni metody likuvannya terminalnoyi fazy zahalnoho perytonitu [Contemporary Methods of Treatment of the Terminal Phase in General Peritonitis]. Ukrayinskyi Zhurnal Khirurhii [Ukrainian Surgery Journal], 6 (15), 90–92.
Dzyubanovskyi, I. Ya., Mihen’ko, B. O. (2009). Syndrom poliorhannoyi nedostatnosti ta yoho korektsiya u khvorykh na hostryi poshyrenyi perytonit [Polyorganic Deficiency Syndrome and Its Corrections in Patients with Acute Extended Peritonitis]. Ukrayinskyi Zhurnal Khirurhii [Ukrainian Surgery Journal], 2, 56–59.
Ivanov, V. H., Vasil’yeva, T. N., Sharayev, P. N. et al. (2006). Laboratornaya diagnostika endohennoi intoksikatsii v klinicheskoi praktike [Laboratory Diagnostics of Endogenic Intoxication in Clinical Practice]. Izhevsk: Federlnoye Agenstvo po Zdravookhraneniyu i Sotsyalnomy Razviiyu HOU VPO.
Syplyvyi, V. A., Kon’, E. V., Yevtushenko, D. V. (2009). Ispol’zovaniye leikotsytarnykh indeksov dlya prognozirovaniya iskhoda peritonita [The Use of Leukocytic Indices for Prognosticating the Consequences of Peritonitis]. Klinichna Khirurhiya [Clinical Surgery], 9, 21–26.
Copyright (c) 2018 Andrii Pavliak
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.