Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://gr.elmerpub.com

Original Article

Volume 19, Number 1, February 2026, pages 28-34

Risk Factors for Mortality in Patients With Strangulating Intestinal Obstruction Who Present With Septic Disseminated Intravascular Coagulation Prior to the Initiation of Treatment

**Table 1.** Patient Background of the Study Subjects
	S group (n = 38)	M group (n = 29)	P value
Continuous variables were expressed as the median (minimum value–maximum value). ASA PS: American Society of Anesthesiologists Physical Status Classification System; S group: survival group; M group: mortality group; NA: not available.
Sex
Male	35 (92.1%)	20 (69.0%)	0.11
Female	3 (7.9%)	9 (32.1%)
Age (years)	68.5 (63–90)	78.5 (62–88)	0.32
ASA PS
ASA I	0	0	NA
ASA II	0	0
ASA III	0	0
ASA IV	38 (100%)	29 (100%)
ASA V	0	0
ASA VI	0	0
Body mass index (kg/m²)	20.2 (13.0–24.2)	19.9 (14.8–28.9)	0.89
Charlson Comorbidity Index	5 (0–8)	3 (0–7)	0.07
Hospital stay (days)	29.5 (15–92)	16 (4–161)	0.41
Overall survival (days)	358 (113–1,188)	34 (14–169)	< 0.001

Table 1. Patient Background of the Study Subjects

S group (n = 38)

M group (n = 29)

P value

Continuous variables were expressed as the median (minimum value–maximum value). ASA PS: American Society of Anesthesiologists Physical Status Classification System; S group: survival group; M group: mortality group; NA: not available.

Sex

Male

35 (92.1%)

20 (69.0%)

0.11

Female

3 (7.9%)

9 (32.1%)

Age (years)

68.5 (63–90)

78.5 (62–88)

0.32

ASA PS

ASA I

ASA II

ASA III

ASA IV

38 (100%)

29 (100%)

ASA V

ASA VI

Body mass index (kg/m²)

20.2 (13.0–24.2)

19.9 (14.8–28.9)

0.89

Charlson Comorbidity Index

5 (0–8)

3 (0–7)

0.07

Hospital stay (days)

29.5 (15–92)

16 (4–161)

0.41

Overall survival (days)

358 (113–1,188)

34 (14–169)

< 0.001

**Table 2.** Treatment Overview
	S group (n = 38)	M group (n = 29)	P value
^aAdditional invasive treatment performed after surgery. Continuous variables were expressed as the median (minimum value–maximum value). S group: survival group; M group: mortality group; rTM: recombinant thrombomodulin; rAT-III: recombinant antithrombin III protein; Glb: immune globulin infusion (human); IPPV: intermittent positive pressure ventilation; PMX-DHP: polymyxin B-immobilized fiber column direct hemoperfusion.
Surgical procedure
Partial small bowel resection	38 (100%)	29 (100%)	NA
Ileostomy	14 (36.8%)	8 (27.6%)	0.43
Jejunostomy or gastrostomy	18 (47.4%)	8 (27.6%)	0.09
rTM administration period	6 (1–10)	4 (1–16)	0.57
Blood transfusion
Packed red blood cells	18 (47.4%)	16 (55.1%)	0.53
Fresh frozen plasma	19 (50.0%)	13 (44.8%)	0.68
Platelet concentrates	1 (2.6%)	2 (6.9%)	0.44
Glb	18 (47.4%)	7 (24.1%)	0.03
rAT-III	36 (94.7%)	28 (96.6%)	0.72
Steroid	8 (21.1%)	3 (10.3%)	0.23
Invasive treatment^a	12 (31.6%)	7 (24.1%)	0.51
IPPV	11 (28.9%)	17(58.6%)	0.02
Intubation period	1 (1–152)	3 (1–44)	0.63
Tracheostomy	7/11 (58.3%)	7/17 (45%)	0.26
Renal replacement therapy	8 (21.1%)	20 (62.5%)	< 0.0001
Duration	3 (3–11)	12 (1–18)	0.36
PMX-DHP	8 (21.1%)	15 (46.9%)	0.01

Table 2. Treatment Overview

S group (n = 38)

M group (n = 29)

P value

^aAdditional invasive treatment performed after surgery. Continuous variables were expressed as the median (minimum value–maximum value). S group: survival group; M group: mortality group; rTM: recombinant thrombomodulin; rAT-III: recombinant antithrombin III protein; Glb: immune globulin infusion (human); IPPV: intermittent positive pressure ventilation; PMX-DHP: polymyxin B-immobilized fiber column direct hemoperfusion.

Surgical procedure

Partial small bowel resection

38 (100%)

29 (100%)

Ileostomy

14 (36.8%)

8 (27.6%)

0.43

Jejunostomy or gastrostomy

18 (47.4%)

8 (27.6%)

0.09

rTM administration period

6 (1–10)

4 (1–16)

0.57

Blood transfusion

Packed red blood cells

18 (47.4%)

16 (55.1%)

0.53

Fresh frozen plasma

19 (50.0%)

13 (44.8%)

0.68

Platelet concentrates

1 (2.6%)

2 (6.9%)

0.44

Glb

18 (47.4%)

7 (24.1%)

0.03

rAT-III

36 (94.7%)

28 (96.6%)

0.72

Steroid

8 (21.1%)

3 (10.3%)

0.23

Invasive treatment^a

12 (31.6%)

7 (24.1%)

0.51

IPPV

11 (28.9%)

17(58.6%)

0.02

Intubation period

1 (1–152)

3 (1–44)

0.63

Tracheostomy

7/11 (58.3%)

7/17 (45%)

0.26

Renal replacement therapy

8 (21.1%)

20 (62.5%)

< 0.0001

Duration

3 (3–11)

12 (1–18)

0.36

PMX-DHP

8 (21.1%)

15 (46.9%)

0.01

**Table 3.** Comparison of Physical and Laboratory Parameters Measured Before Treatment Initiation (Pre) and One Day After Treatment Initiation (Day 1)
	Pre	Day 1
Continuous variables were expressed as the median (minimum value–maximum value). S group: survival group; M group: mortality group; GCS: Glasgow Coma Scale; sNIBP: systolic noninvasive blood pressure; MAP: mean arterial pressure; PaCO₂: arterial partial pressure of carbon dioxide; P/F ratio: Horowitz Index for Lung Function; WBC: white blood cell; Bil: serum total bilirubin level; Cre: serum creatinine level; PT-INR: prothrombin time-international normalized ratio; FDP: plasma fibrin and fibrinogen degradation products level; NA: not available; ND: not detected.
GCS	14 (12–15)	10 (6–15)	0.12	15 (14–15)	12 (10–15)	0.003
Body temperature (°C)	38.3 (35.8–341.2)	37.2 (35.4–39.5)	0.36	36.7 (34.5–37.9)	36.7 (35.9–40.0)	0.67
Heart rate (beats/min)	127 (82–171)	119 (69–150)	0.41	91 (70–113)	119 (78–169)	0.27
Respiratory rate (/min)	28 (20–35)	28 (17–47)	0.9	20 (12–44)	23 (17–43)	0.27
Urine output (mL/day)	1,310 (690–4,700)	920 (690–1,410)	0.06	1,600 (10–3,800)	1,200 (280–2,245)	0.11
sNIBP (mm Hg)	102 (74–132)	89 (75–112)	0.08	118 (96–159)	100 (80–140)	0.36
MAP (mm Hg)	75 (62–90)	66 (60–84)	0.1	84 (71–100)	67 (55–105)	0.27
PaCO₂ (Torr)	25.2 (22–45.9)	25.3 (12.8–48.0)	0.63	30.4 (22–60.9)	41.3 (32.0–64.7)	0.04
P/F ratio	350 (175–455)	212 (106–400)	0.2	328 (210–410)	235 (87–350)	0.03
WBC (/µL)	15,450 (8,600–44,900)	5,150 (1,600–27,200)	0.2	12,700 (5,200–47,600)	2,500 (1,600–19,900)	0.01
Platelet count (× 10⁴/µL)	12.4 (5.1–24.9)	11.7 (2.1–39.6)	0.83	9.4 (0.9–14.4)	10.2 (3.7–37.9)	0.48
Bil (mg/dL)	1.3 (0.5–4.3)	0.7 (0.3–3.1)	0.1	1.2 (0.5–3.6)	0.7 (0.3–6.9)	0.27
Cre (mg/dL)	1.09 (0.56–2.48)	1.48 (0.45–2.8)	0.52	0.99 (0.53–1.52)	1.11 (0.6–3.67)	0.6
PT-INR	1.24 (0.98–1.88)	1.39 (1.02–1.71)	0.46	1.26 (0.97–1.77)	1.37 (0.94–2.1)	0.89
FDP (µg/mL)	11.95 (5.9–17.5)	16.55 (7.7–57.7)	0.17	9.55 (5.9–22.4)	17.1 (6.2–44.6)	0.16
Antithrombin activity (%)	64.5 (39–80)	54.5 (41–70)	0.36	ND	ND	NA

Table 3. Comparison of Physical and Laboratory Parameters Measured Before Treatment Initiation (Pre) and One Day After Treatment Initiation (Day 1)

Pre

Day 1

S group (n = 38)

M group (n = 29)

P value

S group (n = 38)

M group (n = 29)

P value

Continuous variables were expressed as the median (minimum value–maximum value). S group: survival group; M group: mortality group; GCS: Glasgow Coma Scale; sNIBP: systolic noninvasive blood pressure; MAP: mean arterial pressure; PaCO₂: arterial partial pressure of carbon dioxide; P/F ratio: Horowitz Index for Lung Function; WBC: white blood cell; Bil: serum total bilirubin level; Cre: serum creatinine level; PT-INR: prothrombin time-international normalized ratio; FDP: plasma fibrin and fibrinogen degradation products level; NA: not available; ND: not detected.

GCS

14 (12–15)

10 (6–15)

0.12

15 (14–15)

12 (10–15)

0.003

Body temperature (°C)

38.3 (35.8–341.2)

37.2 (35.4–39.5)

0.36

36.7 (34.5–37.9)

36.7 (35.9–40.0)

0.67

Heart rate (beats/min)

127 (82–171)

119 (69–150)

0.41

91 (70–113)

119 (78–169)

0.27

Respiratory rate (/min)

28 (20–35)

28 (17–47)

0.9

20 (12–44)

23 (17–43)

0.27

Urine output (mL/day)

1,310 (690–4,700)

920 (690–1,410)

0.06

1,600 (10–3,800)

1,200 (280–2,245)

0.11

sNIBP (mm Hg)

102 (74–132)

89 (75–112)

0.08

118 (96–159)

100 (80–140)

0.36

MAP (mm Hg)

75 (62–90)

66 (60–84)

0.1

84 (71–100)

67 (55–105)

0.27

PaCO₂ (Torr)

25.2 (22–45.9)

25.3 (12.8–48.0)

0.63

30.4 (22–60.9)

41.3 (32.0–64.7)

0.04

P/F ratio

350 (175–455)

212 (106–400)

0.2

328 (210–410)

235 (87–350)

0.03

WBC (/µL)

15,450 (8,600–44,900)

5,150 (1,600–27,200)

0.2

12,700 (5,200–47,600)

2,500 (1,600–19,900)

0.01

Platelet count (× 10⁴/µL)

12.4 (5.1–24.9)

11.7 (2.1–39.6)

0.83

9.4 (0.9–14.4)

10.2 (3.7–37.9)

0.48

Bil (mg/dL)

1.3 (0.5–4.3)

0.7 (0.3–3.1)

0.1

1.2 (0.5–3.6)

0.7 (0.3–6.9)

0.27

Cre (mg/dL)

1.09 (0.56–2.48)

1.48 (0.45–2.8)

0.52

0.99 (0.53–1.52)

1.11 (0.6–3.67)

0.6

PT-INR

1.24 (0.98–1.88)

1.39 (1.02–1.71)

0.46

1.26 (0.97–1.77)

1.37 (0.94–2.1)

0.89

FDP (µg/mL)

11.95 (5.9–17.5)

16.55 (7.7–57.7)

0.17

9.55 (5.9–22.4)

17.1 (6.2–44.6)

0.16

Antithrombin activity (%)

64.5 (39–80)

54.5 (41–70)

0.36

**Table 4.** Comparison of SIRS Score, qSOFA Score, SOFA Score and DIC Score Measured Before Treatment Initiation (Pre) and One Day After Treatment Initiation (Day 1)
	Pre	Day 1
Continuous variables were expressed as the median (minimum value–maximum value). S group: survival group; M group: mortality group; SIRS score: systemic inflammatory response syndrome score; qSOFA score: quick SOFA score; SOFA score: Sequential Organ Failure Assessment score; DIC score: disseminated intravascular coagulation diagnostic criteria for sepsis.
SIRS score	3 (3–4)	4 (3–4)	0.15	1 (0–2)	2 (1–4)	0.03
qSOFA score	1 (1–3)	2 (2–3)	0.08	1 (0–2)	2 (1–3)	0.003
SOFA score	3 (1–6)	5 (1–9)	0.03	4 (1–7)	6 (2–16)	0.04
DIC score	4 (4–5)	4 (4–6)	0.2	2 (1–4)	5 (4–6)	< 0.001

Table 4. Comparison of SIRS Score, qSOFA Score, SOFA Score and DIC Score Measured Before Treatment Initiation (Pre) and One Day After Treatment Initiation (Day 1)

Pre

Day 1

S group (n = 38)

M group (n = 29)

P value

S group (n = 38)

M group (n = 29)

P value

Continuous variables were expressed as the median (minimum value–maximum value). S group: survival group; M group: mortality group; SIRS score: systemic inflammatory response syndrome score; qSOFA score: quick SOFA score; SOFA score: Sequential Organ Failure Assessment score; DIC score: disseminated intravascular coagulation diagnostic criteria for sepsis.

SIRS score

3 (3–4)

4 (3–4)

0.15

1 (0–2)

2 (1–4)

0.03

qSOFA score

1 (1–3)

2 (2–3)

0.08

1 (0–2)

2 (1–3)

0.003

SOFA score

3 (1–6)

5 (1–9)

0.03

4 (1–7)

6 (2–16)

0.04

DIC score

4 (4–5)

4 (4–6)

0.2

2 (1–4)

5 (4–6)

< 0.001

**Table 5.** Logistic Regression Analysis for Mortality Risk Factor Assessment Targeting Physical and Hematological Parameters
Inspection period	Univariate	Multivariate
GCS: Glasgow Coma Scale; PaCO₂: arterial partial pressure of carbon dioxide; P/F ratio: Horowitz Index for Lung Function; WBC: white blood cell; CI: confidence interval.
Day 1
GCS < 14	28.5	2.07–37.9	0.012			0.59
PaCO₂ > 38.0 (Torr)	12.2	1.29–21.3	0.029			0.98
P/F ratio < 250	12.1	1.94–21.2	0.031			0.11
WBC < 8,000 (/µL)	63.3	3.32–119.4	0.006	19.8	3.64–72.6	0.012

Table 5. Logistic Regression Analysis for Mortality Risk Factor Assessment Targeting Physical and Hematological Parameters

Inspection period

Univariate

Multivariate

Odds ratio

95% CI

P value

Odds ratio

95% CI

P value

GCS: Glasgow Coma Scale; PaCO₂: arterial partial pressure of carbon dioxide; P/F ratio: Horowitz Index for Lung Function; WBC: white blood cell; CI: confidence interval.

Day 1

GCS < 14

28.5

2.07–37.9

0.012

0.59

PaCO₂ > 38.0 (Torr)

12.2

1.29–21.3

0.029

0.98

P/F ratio < 250

12.1

1.94–21.2

0.031

0.11

WBC < 8,000 (/µL)

63.3

3.32–119.4

0.006

19.8

3.64–72.6

0.012

Table 6. Logistic Regression Analysis for Mortality Risk Factor Assessment Targeting SIRS Score, qSOFA Score, SOFA Score and DIC Score

Inspection period

Univariate

Multivariate

Odds ratio

95% CI

P value

Odds ratio

95% CI

P value

Pre: before treatment initiation; Day 1: 1 day after treatment initiation; SIRS score: systemic inflammatory response syndrome score; qSOFA score: quick SOFA score; SOFA score: Sequential Organ Failure Assessment score; DIC score: disseminated intravascular coagulation diagnostic criteria for sepsis; CI: confidence interval.

Pre

SOFA score > 4

0.16

Day 1

SIRS score > 2

0.29

qSOFA score > 2

1.88

1.03–15.22

0.04

0.15

SOFA score > 4

0.26

DIC score > 4

2.31

1.78–31.82

0.02

1.75

1.27–9.34

0.04