Background: Intensive Care Units (ICUs) provide critical support for patients after major surgery or acute abdominal conditions. Despite medical advances, mortality remains high in surgical ICU patients. This study aimed to identify clinical and biochemical predictors of mortality in surgical patients admitted to a tertiary ICU. Methods: We conducted a retrospective case–control study on 231 adult general surgery patients admitted to a tertiary anesthesia ICU between January 2018 and December 2023. Patients under 18 years or who underwent solid organ transplantation were excluded. Data collected included demographic, clinical, and laboratory parameters such as the Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP)/albumin ratio. Patients were divided into mortality and survival groups, with subgroup analyses performed for malignancy, sepsis, and trauma. Receiver operating characteristic (ROC) curve and Cox regression analyses were used to identify mortality predictors. Results: The ICU mortality rate was 64.9%. Significant predictors included age ≥ 58 years (odds ratio [OR] 4.56), body mass index (BMI) > 30 kg/m² (OR 7.62), mean arterial pressure < 70 mmHg (OR 1.66), serum albumin < 21.3 g/L (OR 1.5), APACHE II > 18.5 (OR 2.42), and SOFA > 9.5 (OR 2.68). Mortality was also associated with lower GCS scores, prolonged mechanical ventilation, and inotropic support. The CRP/albumin ratio was significantly elevated in the mortality group (p = 0.024). Other inflammatory markers showed no significant differences. Predictive factors varied among subgroups. Conclusions: Older age, obesity, hypotension, hypoalbuminemia, and high severity scores independently predict mortality in surgical ICU patients. Early risk identification may enhance management and improve outcomes in this population.

Emergency surgeries are linked with increased morbidity and reduced life expectancy, often associated with low socioeconomic status, limited access to healthcare, and delayed hospital admissions. While the influence of socioeconomic status on elective surgery outcomes is well-established, its impact on emergency surgeries, including ostomy creation and closure, is less clear. This study aimed to explore how the pandemic and socioeconomic status affect emergency ostomy procedures, seeking to determine which has a greater effect. It emphasizes the importance of considering socioeconomic factors in patient care pathways for ostomy procedures. A total of 542 patients who underwent emergency ostomy formation between 2016 and 2022 were retrospectively analyzed and divided into pre-pandemic and pandemic periods. The pre-pandemic and pandemic periods were compared between themselves and against each other. Demographic data (age and sex), comorbidities, socioeconomic status, etiology of the primary disease, type of surgery, stoma type, length of hospital stay, ostomy closure time, and postoperative complications were retrospectively analyzed for all patients. In total, 290 (53%) patients underwent surgery during the pandemic period, whereas 252 (47%) underwent surgery during the pre-pandemic period. Emergency surgery was performed for malignancy in 366 (67%) patients. The number of days patients underwent ostomy closure was significantly higher in the low-income group ( P = .038, 95% CI: 293,2, 386–945). The risk of failure of stoma closure was 3-fold (95% CI: 1.8–5.2) in patients with metastasis. The risk of mortality was 12.4-fold (95% CI: 6.5–23.7) when there was failure of stoma closure. When compared to pandemic period, the mortality risk was 6.3-fold (95% CI: 3.9–10.2) in pre-pandemic period. Pandemic patients had a shorter hospital stay than before the pandemic ( P = .044). A high socioeconomic status was significantly associated with early hospital admission for ostomy closure, and lower probability of mortality. More metastases and perforations were observed during the pandemic period and mortality was increased during pandemic and in patients without ostomy closure. The socioeconomic status lost its effect in cases of emergency ostomy creation and had no impact on length of hospital stay in either the pre-pandemic or pandemic period.

Background: Intensive Care Units (ICUs) provide critical support for patients after major surgery or acute abdominal conditions. Despite medical advances, mortality remains high in surgical ICU patients. This study aimed to identify clinical and biochemical predictors of mortality in surgical patients admitted to a tertiary ICU. Methods: We conducted a retrospective case-control study on 231 adult general surgery patients admitted to a tertiary anesthesia ICU between January 2018 and December 2023. Patients under 18 or who underwent solid organ transplantation were excluded. Data collected included demographic, clinical, and laboratory parameters such as Glasgow Coma Scale (GCS), APACHE II, SOFA, HALP scores, neutrophil/lymphocyte ratio (NLR), CRP/albumin ratio, and others. Patients were divided into mortality and survival groups, with subgroup analyses for malignancy, sepsis, and trauma. ROC and Cox regression analyses identified mortality predictors. Results: The ICU mortality rate was 64.9%. Significant predictors included age ≥58 (OR 4.56), BMI >30 (OR 7.62), mean arterial pressure <70 mmHg (OR 1.66), serum albumin 18.5 (OR 2.42), and SOFA >9.5 (OR 2.68). Mortality was significantly associated with lower GCS, prolonged ventilation, inotropic support, and notably, a significantly elevated CRP/albumin ratio in the mortality group (p=0.024). Other inflammatory markers showed no significant difference. Predictive factors varied among subgroups. Conclusion: Older age, obesity, hypotension, hypoalbuminemia, and high severity scores independently predict mortality in surgical ICU patients. Early risk identification may enhance management and improve outcomes in this population.

We aimed to evaluate, within a single-surgeon, predefined, approach-specific mesh protocol, whether the surgical approach (laparoscopic vs. open) is independently associated with long-term recurrence after adjusting for patient-related factors. A total of 314 patients who underwent surgery using both laparoscopic and open techniques between 2013 and 2022 by a single expert general surgeon were analyzed. The patients’ age, gender, hernia side, body mass index (BMI), comorbidities, preoperative American Society of Anesthesiologists scores, type of operation, postoperative complications, and recurrence rates during follow-up were retrospectively reviewed from the Electronic Patient File (EPF) system. Repairs followed a predefined, approach-specific mesh protocol (self-gripping mesh for open repairs; pre-formed polypropylene mesh for laparoscopic repairs). The median follow-up duration was 72 months (IQR 56.5–102; range 26–140 months). Overall recurrence was observed in 24 of 314 patients (7.6%) during follow-up. Crude rates were similar between approaches (7.3% after open [14/192] vs. after laparoscopic 8.2% [10/122], p = 0.769). In multivariable analysis, diabetes mellitus, cardiovascular disease, and prior repair emerged as independent predictors of recurrence. In a standardized setting minimizing surgeon and implant heterogeneity, recurrence was approximately 8% at a median follow-up of about 6 years and was primarily associated with patient-related factors, such as comorbidity and prior repair, rather than surgical approach. Within the context of this cohort, these findings should be interpreted as hypothesis-generating and may reflect recurrence patterns observed under standardized conditions, rather than a definitive lower-bound benchmark. They also highlight the potential relevance of pre- and perioperative risk optimization beyond surgical approach selection alone.

Aim: Gastric cancer is the fifth most common cancer in the world and the third most common cause of cancer related deaths. Its incidence is also increasing in elderly patients. A patient based, multidisciplinary treatment approach is required in the evaluation of elderly patients. Surgical resection is the curative method in the treatment of gastric cancer. We aimed to evaluate the early surgical outcomes, mortality and morbidity of patients aged 80 years and older who were operated for gastric cancer. Materials and Methods: Patients aged 80 years and older who underwent surgery for gastric adenocarcinoma between January 2015 and June 2022 were retrospectively analyzed. Demographic, clinical, and histopathological parameters and postoperative outcomes were evaluated. Results: Twenty three patients aged 80 years and older were included in the study. The mean age was 81.95 ± 3.11 (Range 80 96) years. 8 were female and 15 were male. 5 patients were ASA I, 11 patients were ASA II, and 7 patients were ASA III. Three patients received neoadjuvant chemotherapy. Total gastrectomy was performed in 11 patients, distal gastrectomy in 5 patients, and proximal gastrectomy in 7 patients. The mean number of lymph nodes removed was 19.87±12.61. The mean hospital stay length was 9.34 ± 3.45 days. The mortality rate in the first ninety days of our study was 8.69% and morbidity was 13,04%. Conclusion: Octogenarians are a special patient group. The treatment plan should be individualized. If possible, all medically fit patients should undergo curative surgery.