Overview
This study aims to evaluate the prognostic significance of CLI in predicting 28-day mortality and other outcomes in critically ill patients who develop post-operative abdominal sepsis.
Eligibility
Inclusion Criteria:
Age ≥ 18 years.
Postoperative secondary peritonitis requiring ICU admission, with clinical evidence of:
Diffuse or localized abdominal pain/tenderness. Peritoneal signs (e.g., guarding, rigidity, rebound tenderness). Imaging or intraoperative confirmation of purulent/exudative intra-abdominal fluid.
Systemic inflammation (e.g., fever, leukocytosis, or vasopressor requirement). Sepsis diagnosis per Sepsis-3 criteria: Suspected/confirmed infection with acute increase in SOFA score ≥2 points (6).
Anticipated ICU stay ≥48 hours postoperatively.
Exclusion Criteria:
- Pregnancy
- Advanced liver disease (Child-Pugh class B or C) that might independently affect albumin levels
- Advanced kidney disease (CKD stage 4 or 5) or patients on chronic dialysis
- Expected mortality within 48 hours of ICU admission
- Patients with primary peritonitis or tertiary peritonitis
- Immunocompromised patients (e.g., on chronic immunosuppressive therapy, solid organ transplant recipients, patients with HIV and CD4 count \<200/mm³)
- Patients with pre-existing systemic inflammatory diseases that might affect baseline CRP levels
- Patients participating in interventional trials that might affect outcomes