Abstract

ABSTRACT:
BACKGROUND
An attempt to find a prediction method of death risk in patients affected by acute mediastinitis. There is not such a tool described in available literature for that serious disease.
METHODS
The study comprised 44 consecutive cases of acute mediastinitis. General anamnesis and biochemical data were included. Factor analysis was used to extract the risk characteristic for the patients. The most valuable results were obtained for 8 parameters which were selected for further statistical analysis (all collected during few hours after admission). Three factors reached Eigenvalue >1. Clinical explanations of these combined statistical factors are: Factor1 - proteinic status (serum total protein, albumin, and hemoglobin level), Factor2 - inflammatory status (white blood cells, CRP, procalcitonin), and Factor3 - general risk (age, number of coexisting diseases). Threshold values of prediction factors were estimated by means of statistical analysis (factor analysis, Statgraphics Centurion XVI).
RESULTS
The final prediction result for the patients is constructed as simultaneous evaluation of all factor scores. High probability of death should be predicted if factor 1 value decreases with simultaneous increase of factors 2 and 3. The diagnostic power of the proposed method was revealed to be high [sensitivity =90%, specificity =64%], for Factor1 [SNC = 87%, SPC = 79%]; for Factor2 [SNC = 87%, SPC = 50%] and for Factor3 [SNC = 73%, SPC = 71%].
CONCLUSION
The proposed prediction method seems a useful emergency signal during acute mediastinitis control in affected patients.

Links

Publisher Full Text

Authors

Jabłoński S, Kozakiewicz M

Institution

Department of Thoracic Surgery, General and Oncological Surgery, Medical University of Lodz, 113 Żeromskiego St,, 90-547, Łódź, Poland. jablonski_s@vp.pl.

Source

World journal of emergency surgery : WJES 7:1 2012 pg 11

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22574625