The morbidity and mortality of emergent operations for colorectal disease.
p6 participants in the Veterans Administration Cooperative Studies Program investigating antibiotic prophylaxis in colorectal operations, 693 consecutive patients (1978-1981) from three hospitals were studied. This report concerns 20% of these patients who presented with either perforation, obstruction, or hemorrhage necessitating emergent surgical intervention on unprepared bowel. The 30-day, in-hospital mortality of the 138 patients undergoing emergency operations was 28%. Elective colorectal procedures during the same period had a six per cent mortality rate. There is a striking difference in the cause of death in prepared patients and those needing emergent surgery. Death in prepared patients was usually of a vascular etiology, while septic-related mortality was present in only one per cent. On the other hand, despite massive doses of antibiotics, fecal diversion, surgical drainage and lavage, abdominal sepsis was documented in 20% and septic related mortality was present in 17% of patients undergoing emergency operations. Early, elective treatment and prevention of obstruction and perforation will improve our results in colorectal disease.
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000401:mortality; D003108:Colonic Diseases / Q000401:mortality / Q000601:surgery*; D004630:Emergencies; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D006760:Hospitalization; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications; D007416:Intestinal Perforation / Q000150:complications; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011292:Premedication; D012002:Rectal Diseases / Q000401:mortality / Q000601:surgery*; D012306:Risk; D013530:Surgical Wound Infection / Q000517:prevention & control
D000900:Anti-Bacterial Agents