The clinical evaluation of sepsis-1 and sepsis-3 in patients with acute surgical abdominal pathology

Purpose of the study. Comparison Sepsis-1 andSepsis-3 use in clinical practice at patients withacute surgical abdominal pathology.Materials and methods. The treatment resultsof 3302 patients with acute surgical abdominalpathology, which were operated at the clinic of theChair of surgery and endoscopy at Lviv DanyloHalytskyi national medical university in 2008–2018are analysed. In 272 (8,2%) cases there weresigns of abdominal sepsis (AS). Gram-negativeflora (E. coli in 198 (72,8%) of patients) was themost common cause of infection. We evaluatedclinical and laboratory characteristics, whichare used for stratification of patients accordingto classifications Sepsis-1 and Sepsis-3.Results. Patients were stratified usingSepsis-1, of which 227 (83,5%) were diagnosedusing Sepsis-3 (SOFA 2). Mortality amongpatients with Sepsis-1 was 41,2% (112/272),among those with Sepsis-3 – 45,4% (103/227).Using Sepsis-3, 45 (16,5%) patients wereexcluded; values of APACHE II and SOFA,as well as length of stay in these patientswas significantly lower; no deaths occurred.Therefore, diagnostic criteria of Sepsis-3significantly reduce the number of patients withacute surgical abdominal pathology, complicatedAS, compared with Sepsis-1. Diagnostic valueof various factors that allow early detectionof sepsis in the absence of an ideal standard isimportant.Conclusion. Indicators of Sepsis-3 areinformative in the diagnosis and staging ofabdominal sepsis.Keywords: acute abdominal surgical pathology,abdominal sepsis, Sepsis-1, Sepsis-3, mortality.