Key result
Inadequate fluids linked to ~228% higher septic shock risk in perioperative non-traumatic abdominal surgery.
Why the study?
Patients experience septic shock in the perioperative period following non-traumatic abdominal emergency surgery, requiring knowledge of its magnitude and factors in resource-limited settings to guide interventions.
What is the prevalence and what are the associated factors of septic shock among adult non-traumatic emergency abdominal surgical patients during the perioperative period?
What is the prevalence and what are the associated factors of septic shock among adult non-traumatic emergency abdominal surgical patients during the perioperative period?
The prevalence of septic shock is high (37.4%) among adult non-traumatic emergency abdominal surgical patients in Northwestern Ethiopia, driven by factors like inadequate fluid resuscitation, lack of vasopressors, and delayed presentation.
** Warrants vigilant fluid resuscitation and vasopressor use in emergency abdominal surgery; hypothesis-generating observational data leaves open causality pending RCTs.
Background: Non-traumatic abdominal emergency surgery is a common surgical procedure globally. Following this, patients experience septic shock in the perioperative period. Therefore, in resource-limited settings, to take the right intervention, it is vital to know the degree of the problem and its factors. The aim of this study was to determine the prevalence rate and to identify the associated factors of septic shock during the perioperative period. Method: An institution-based cross-sectional study was conducted at North West Amhara Region Specialized Hospitals between mid-February 2023 and July 15, 2023. Consecutively, a total of 409 patients were included. The data was entered and analyzed with SPSS version 20. The association between independent factors and the outcome variable was determined at 95% CI with crude odds ratio and adjusted odds ratio for bivariable and multivariable logistic regression. Hosmer and Lemeshow tests were used to assess the goodness of fit. The P -value < 0.05 was statically significant. Result: Out of 409 patients, 153 patients met the septic shock criterion, with a prevalence of 37.4% (95% CI: 0.33, 0.42). In multivariate analysis, non-administered vasopressor (AOR: 2.63, 95% CI: 1.20, 5.77), inadequate intravenous fluid (AOR: 3.28, 95% CI: 1.8, 5.99), rural residency (AOR: 1.87, 95% CI: 1.01, 3.46), and duration of illness longer than 24 h (AOR: 1.47, 95% CI: 1.23, 6.98) were significantly associated with septic shock. Conclusion and recommendation: The prevalence of septic shock was relatively high (37.4%). Non-vaso-active resuscitation, inadequate intravenous fluid, rural residency, and duration of illness longer than 24 h were significantly associated with septic shock. Interventions like adequate fluid resuscitation, early vasoactive drug administration, and shortening the duration of illness could decrease the prevalence of septic shock.
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Alemu et al. (2025) studied this question. Septic shock prevalence was 37.4% in perioperative non-traumatic abdominal surgery patients; inadequate fluids (AOR 3.28) and no vasopressors (AOR 2.63) increased risk.
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