Cardiothoracic and Vascular Anesthesia

Current Concepts in the Management of Esophageal Perforations: A Twenty-Seven Year Canadian Experience

Bhatia P, Fortin D, Inculet RI, et al (The Univ of Western Ontario, London, Ontario, Canada) Ann Thorac Surg 92:209-215, 2011^§

Abstract

Background

Perforation of the esophagus remains a challenging clinical problem.

Methods

A retrospective review was performed of patients diagnosed with an esophageal perforation admitted to the London Health Sciences Centre from 1981 to 2007. Univariate and multivariate logistic regression was used to determine which factors had a statistically significant effect on mortality.

Results

There were 119 patients; 15 with cervical, 95 with thoracic, and 9 with abdominal perforations. Fifty-one percent of all the perforations were iatrogenic and 33% were spontaneous. Multivariate logistic regression analysis revealed that patients with preoperative respiratory failure requiring mechanical ventilation had a mortality odds ratio of 32.4 (95% confidence interval [CI] 3.1 to 272.0), followed by malignant perforations with 20.2 (95% CI 5.4 to 115.6), a Charlson comorbidity index of 7.1 or greater with 19.6 (95% CI 4.8 to 84.9), the presence of a pulmonary comorbidity with 13.9 (95% CI 2.9 to 97.4), and sepsis with 3.1 (95% CI 1.0 to 10.1). A wait time of greater than 24 hours was not associated with an increased risk of mortality (p = 0.52).

Only gold members can continue reading. Log In or Register to continue

Share this:

• Click to share on Twitter (Opens in new window)
• Click to share on Facebook (Opens in new window)

Related

Related posts:

of change in daily step count over five years with insulin sensitivity and adiposity: population based cohort study of Cancer: The Next Generation Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A meta-analysis time and haemodynamic response after thiopental vs. propofol in the elderly: a randomized trial monitoring of neuromuscular block over the orbicularis oris muscle in anesthetized patients receiving vecuronium Is Better Than General Anesthesia During Endovascular Acute Stroke Interventions