Paraplegic and quadriplegic patients undergoing emergency abdominal surgery: sicker presentations, worse outcomes

The Journal of Trauma and Acute Care Surgery
Elizabeth BenjaminDemetrios Demetriades

Abstract

Patients with paraplegia or quadriplegia presenting with abdominal surgical emergencies pose major clinical challenges. Difficulties in prompt diagnosis and treatment may influence patient outcomes. This is an American College of Surgeons National Surgical Quality Improvement Program study of patients undergoing an emergent abdominal operation. Patients were stratified into paraplegic (PARA), quadriplegic (QUAD), and control (CONT). PARA and QUAD groups were matched with controls by 1:2 ratio. Regression models were used to analyze the effect of paraplegia and quadriplegia on outcome. A total of 76,766 patients underwent emergent abdominal operations: 274 PARA, 132 QUAD, and 76,356 CONT patients. Lower gastrointestinal operations were the most common procedures in PARA and QUAD groups; appendectomy was the most common in the CONT group. After cohort matching, patients with cord paralysis were significantly more likely to present with severe sepsis, have "infected" wounds at operation, and have increased rates of postoperative sepsis and need for reoperation. Patients with paraplegia or quadriplegia with acute abdominal surgical emergencies are more likely to present late and have a significantly higher incidence of postoperativ...Continue Reading

References

Sep 1, 1975·Archives of Surgery·K J CharneyA E Comarr
Nov 1, 1990·Annals of Surgery·L A NeumayerC W Putnam
Feb 1, 1990·Diseases of the Colon and Rectum·W E LongoI M Modlin
Dec 1, 1995·Paraplegia·Z Bar-On, A Ohry
Dec 28, 1999·American Journal of Surgery·G R StrautherF E Johnson
Jul 7, 2001·Archives of Physical Medicine and Rehabilitation·K R Poduri, E M Schnitzer
Jul 14, 2001·ANZ Journal of Surgery·B J MillerJ R Cohen
Jan 10, 2004·Surgery Today·Atsushi MatsuoTomohiko Furuta

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Citations

Mar 7, 2018·ANZ Journal of Surgery·Darius AshrafiPeter Mactaggart

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