Authors: Lokesh K P et al.
Cureus 17(10): e95479, October 26, 2025. DOI: 10.7759/cureus.95479
This prospective single-centre study followed 92 adult general-surgery patients who required postoperative mechanical ventilation (mostly emergencies). Thirty-day in-hospital mortality was high (59/92). Non-survivors more often developed ventilator-associated pneumonia (VAP) and multiple organ dysfunction syndrome (MODS). Higher risk signals included qSOFA ≥2, ASA >3, elevated APACHE II, coagulopathy (higher INR), hypoalbuminemia, thrombocytopenia, and adverse procalcitonin trends. About a third needed transfusion; 16% underwent tracheostomy. Elective cases were rare and generally fared better, though severe postoperative infection could still be fatal. The authors highlight that delayed presentation in septic shock and bowel catastrophe (e.g., perforation peritonitis, SMA thrombosis with gangrene) likely drove the mortality burden.
What You Should Know
• qSOFA ≥2 and ASA >3 flagged patients at significantly higher risk of VAP, MODS, and 30-day mortality; APACHE II added prognostic value.
• Lab markers aligned with outcomes: higher INR, low albumin, lower platelets, and rising/persistently high procalcitonin tracked with death.
• Extubation failure clustered with VAP and MODS—arguing for aggressive infection control, early hemodynamic optimization, and structured weaning.
• In resource-limited ICUs, these bedside scores and biomarkers can prioritize monitoring, guide counseling, and target early interventions.
Thank you to Cureus for allowing us to use this article.