Early clinical and laboratory predictors of in-hospital mortality in patients with postoperative abdominal sepsis

Aim. To identify early clinical and laboratory predictors of death in patients with postoperative abdominal sepsis in the first 48 hours after its verification.

Materials and мethods. A retrospective study was conducted on 40 patients with abdominal sepsis hospitalized in the surgical department of Siberian State Medical University in 2019–2023. All patients were divided into groups according to the outcome of hospitalization (discharge or death). Clinical and anamnestic data, Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) scores, and dynamic changes in biochemical and hematological markers were evaluated (T1– at verification, T2 – after 48 hours). The Mann – Whitney U test, χ² test, Wilcoxon test, and ROC analysis were applied.

Results. The mortality rate was 45%. Statistically significant predictors of mortality were: SOFA score > 4, serum urea > 12.1 mmol / l, calcium ≤ 1.8 mmol / l, platelet count ≤ 264 × 10⁹ / l, no platelet increase > 15 × 10⁹ / l, neutrophil reactivity intensity (NEUT-RI) > 57.6 fluorescence intensity (FI) at T1 and > 53.8 FI at T2. Prognostic values were also established for reticulocyte parameters and reactive lymphocyte content.

Conclusion. Early assessment of clinical and laboratory parameters, especially indicators of kidney function, calcium metabolism, blood count, and the intensity of the inflammatory response, has high prognostic value in postoperative sepsis and can be used for risk stratification and optimization of therapy.

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