Preoperative Prediction of Severe Intestinal Ischemia in Strangulation Ileus

Yoichi Kawahira, Nobuhiro Fujita, Kazuyasu Nakao, Masayasu Hamaji, Katsuaki Maeda, Tadashi Nishimura, Masaaki Nakahara, Yasuro Kishimoto, Nobuo Ogino, Yoshifumi Naka, Junichi Hasegawa, Akihiro Yoneda, Fumihiro Uchikoshi, Hiromu Kazuo, Akira Maeda

Department of Emergency and Critical Care Medicine and Surgery, Osaka Police Hospital

In order to determine preoperatively the presence of severe intestinal ischemia requiring resection, retrospective multiple regression analysis was conducted by various parameters in 65 surgical patients. The patients fell into two groups, an intestinal resection group (35 patients) and a non-resection group (30 patients). WBC, rate of left shift of granulocytes (RLS) and blood glucose levels (BG) were significantly higher in the resection group than in the non-resection group. On simple regression analysis, the length of the resected intestine was significantly correlated with body temperature (BT), WBC, RLS, CPK and BG. On multiple regression analysis, the length of the resection was also significantly correlated with WBC, RLS and serum level of CPK. The serum level of CPK was the most responsible in terms of standard partial regression coefficient. The linear discriminant function using BT, CPK and BG which we propose here revealed 90% accuracy of the true discriminant rate. In conclusion, with retrospective multivariate analysis, preoperative BT, WBC, RLS, CPK and BG proved to be responsible for the prediction of severe intestinal ischemia to be resected in 65 patients with strangulation ileus.

Key words
strangulation ileus, prediction of intestinal ishcemia, multi-variate analysis

Reprint requests
Yoichi Kawahira Department of Surgery, Osaka Police Hospital
10-31 Kitayamacho, Tennojiku, Osaka, 543 JAPAN

Accepted
October 9, 1991

To read the PDF file you will need Abobe Reader installed on your computer.