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03-02-2025 | Colectomy | Original Article

Novel prognostic score for colorectal necrosis requiring emergency surgery

Authors: Kensuke Kudou, Shuhei Kajiwara, Takashi Motomura, Takafumi Yukaya, Tomonori Nakanoko, Yosuke Kuroda, Masahiro Okamoto, Tadashi Koga, Yo-Ichi Yamashita, Mototsugu Shimokawa, Eiji Oki, Tomoharu Yoshizumi

Published in: Surgery Today

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Abstract

Purpose

Colorectal necrosis is a serious condition associated with high morbidity and mortality. We investigated the clinical features and prognostic factors of patients who underwent emergency surgery for colorectal necrosis.

Methods

Data from 40 patients who underwent surgery for colorectal necrosis were reviewed retrospectively to assess the various clinical and operative factors and risk factors for hospital mortality.

Results

The Kaplan–Meier method showed that total colectomy, a platelet count < 100,000/μL, a prothrombin time-international normalized ratio ≥ 1.5, creatine kinase ≥ 566 U/L, lactate ≥ 22.8 mg/dL, base excess < − 12 mmol/L, platelet-lymphocyte ratio < 321, and C-reactive protein/albumin ratio < 1.0 were significantly associated with poor prognosis. Multivariate analyses identified that a platelet count < 100,000/μL (hazard ratio = 7.101, p = 0.0070) and base excess < -12 mmol/L (hazard ratio = 3.663, p = 0.0464) were independent predictive factors for hospital mortality in patients with colorectal necrosis. We established a novel prognostic score based on platelet count, creatine kinase, and base excess. Patients with a novel prognostic score ≥ 4 had significantly poorer survival rates than patients with a score ≤ 3 (0.0% vs. 73.4%, p < 0.001).

Conclusions

A platelet count < 100,000/μL and base excess < − 12 mmol/L are associated with a poor prognosis for patients with colorectal necrosis. This novel prognostic score may be a more accurate prognostic factor for patients with colorectal necrosis.
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Metadata
Title
Novel prognostic score for colorectal necrosis requiring emergency surgery
Authors
Kensuke Kudou
Shuhei Kajiwara
Takashi Motomura
Takafumi Yukaya
Tomonori Nakanoko
Yosuke Kuroda
Masahiro Okamoto
Tadashi Koga
Yo-Ichi Yamashita
Mototsugu Shimokawa
Eiji Oki
Tomoharu Yoshizumi
Publication date
03-02-2025
Publisher
Springer Nature Singapore
Published in
Surgery Today
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-025-03002-4
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