PREDICTION OF MULTIPLE ORGAN DYSFUNCTION DEVELOPMENT IN ACUTE ABDOMINAL SURGICAL PATHOLOGY

Abstract

The incidence of acute abdominal surgical pathology continues to increase annually due to various factors. Patients also demonstrate a rising prevalence of septic complications accompanied by multiple organ dysfunction. Objective. The aim of the study is to develop an effective method for predicting sepsis development and its potential severe complications, specifically multiple organ dysfunction. Materials and Methods. A clinical and laboratory examination was conducted on 60 patients aged 18–70 years (mean age: 45.2±3.6 years), including 34 (56.67 %) men and 26 (43.33 %) women. The participants were divided into three groups (n=20). In the first (control) group, surgeries were elective and included laparoscopic cholecystectomy, inguinal hernioplasty, colostomy closure, and resection of large bowel diverticula. In the second and third groups, surgical treatment was performed on an emergency basis and included the following procedures: laparotomy followed by adhesiolysis; ileocolic anastomosis; suturing of hollow organ wall defects, and peritoneal lavage and drainage. Gynecological patients underwent total abdominal hysterectomy. The second group included patients with early postoperative complications of the primary pathology, specifically localized peritonitis without organ dysfunction. The third group consisted of patients with various postoperative organ dysfunction, requiring organ support (mechanical ventilation, renal replacement therapy, and vasopressor support). In each group, the ISIRI, peripheral blood monocyte ratio, procalcitonin levels, and presepsin levels were determined. Results. All patients with ISIRI>1.40 and a simultaneous increase in the proportion of intermediate monocytes developed sepsis combined with multiple organ dysfunction. Conclusion. The developed method provided effective early diagnosis of both sepsis and its severe complications, such as multiple organ dysfunction, thereby facilitating earlier adjustments to diagnostic and treatment strategies.