Predictor of Mortality in Complicated Intraabdominal Infection Patients at Dr. Soetomo General Hospital Surabaya

Background: Complicated intraabdominal infection (cIAI) is a surgical emergency reported to be a major contributor to non-traumatic mortality worldwide. Identifying the mortality risk before any operation is important in guiding clinical decision-making and informed patient consent about the risk of complicated intraabdominal infection (cIAI). The study aimed to develop a novel scoring system for predicting postoperative mortality in cIAI. Methods: Data were collected retrospectively from all consecutive patients 396 patients met the inclusion criteria after excluding missing data undergoing cIAI surgery in Dr. Soetomo Hospital 2020-2022. Multivariate logistic regression analysis was performed to correlate the explanatory variable postoperative mortality. Data were analyzed using SPSS version 20.0 for Windows and MedCalc. Results: Postoperative mortality rate cIAI was 32,2% (128 of 396), and variables identified as the strongest predictors of postoperative mortality were age > 60 y.o (OR 3,196), systolic blood pressure < 100 mmHg (OR 5,894), thrombocyte < 100.000 /uL (OR 5,593), albumin ≤ 2,9 g/dL (OR 6,764), total bilirubin > 1,8 mg/dL (OR 2,180), creatinine serum ≥ 1,58 mg/dL (OR 4,290), cancer comorbidity (OR 3,578), and appendix perforation as negative predictor (OR 5,853). These parameters were included in the prediction model of the novel simplified Airlangga Scoring System. Conclusion: Despite the relatively low number of risk factors, the Airlangga score has been shown as a good predictor of postoperative mortality after cIAI. External validation is required in hospitals different from those in which the novel scoring system was developed.