“Dirty mass” is a specific computed tomography (CT) finding that is seen frequently in colorectal perforation. The prognostic significance of this finding for mortality is unclear. Fifty-eight consecutive patients with colorectal perforation who underwent emergency surgery were retrospectively reviewed in the study. Dirty mass identified on multi-detector row CT (MDCT) was 3D-reconstructed and its volume was calculated using Ziostation software. Dirty mass volume and other clinical characteristics were compared between survivor (n = 45) and mortality groups (n = 13) to identify predictive factors for mortality. Mann–Whitney U test and Χ2 test were used in univariate analysis and logistic regression analysis was used in multivariate analysis. Dirty mass was identified in 36/58 patients (62.1%) and located next to perforated colorectum in all cases. Receiver-operating characteristic (ROC) curve analysis identified the highest peak at 96.3 cm3, with sensitivity of 0.643 and specificity of 0.864. Univariate analysis revealed dirty mass volume, acute disseminated intravascular coagulation (DIC) score, acute physiology and chronic health evaluation II (APACHE II) score, and sequential organ failure assessment (SOFA) score as prognostic markers for mortality (p<0.01). Multivariate analysis revealed dirty mass volume and APACHE II score as independent prognostic indicators for mortality. Mortality was stratified by dividing patients into four groups according to dirty mass volume and APACHE II score. The combination of dirty mass volume and APACHE II score could stratify the postoperative mortality risk in patients with colorectal perforation. According to the risk stratification, surgeons might be able to decide the surgical procedures and intensity of postoperative management.

中文翻译：

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脏肿块体积与APACHE II评分联合预测结直肠穿孔患者死亡率

“脏块”是一种特定的计算机断层扫描 (CT) 发现，在结直肠穿孔中经常看到。这一发现对死亡率的预后意义尚不清楚。该研究对 58 名接受急诊手术的连续结直肠穿孔患者进行了回顾性研究。在多排CT (MDCT) 上识别出的脏块经过3D 重建，并使用Ziostation 软件计算其体积。比较幸存者 (n = 45) 和死亡率组 (n = 13) 的脏块体积和其他临床特征，以确定死亡率的预测因素。单变量分析采用Mann-Whitney U检验和Χ2检验，多变量分析采用逻辑回归分析。在 36/58 名患者 (62.1%) 中发现脏肿块，并且在所有病例中都位于穿孔的结肠直肠旁。接受者操作特征 (ROC) 曲线分析确定了 96.3 cm3 处的最高峰，灵敏度为 0.643，特异性为 0.864。单变量分析显示脏质量体积、急性播散性血管内凝血 (DIC) 评分、急性生理学和慢性健康评估 II (APACHE II) 评分和序贯器官衰竭评估 (SOFA) 评分是死亡率的预后标志物 (p<0.01)。多变量分析显示脏质量体积和 APACHE II 评分是死亡率的独立预后指标。通过根据脏质量体积和 APACHE II 评分将患者分为四组，对死亡率进行分层。脏块体积和 APACHE II 评分的结合可以对结直肠穿孔患者的术后死亡风险进行分层。根据风险分层，