title: [Relaparotomy on demand: factors related to mortality].
abstract: OBJECTIVE
  To assess the mortality related factors of patients after relaparotomy on demand.
  
  
  BACKGROUND
  In some patients, a relaparotomy after a primary laparotomy will be necessary, most due to acute complications. The relaparotomy can be planned or on demand based on the evolution of the patient. Which of these approaches is better is still a matter of debate.
  
  
  METHODS
  Thirty three patients underwent relaparatomy on demand in a general surgery unit.
  
  
  RESULTS
  Of 51 relaparotomies, 98% were positive. Nineteen of the 33 patients died, resulting in a mortality rate of 58%. The factors associated with mortality were development of an intestinal fistula (p < 0.02), wound infection (p < 0.03), generalized peritonitis in the primary surgery (p < 0.001), urgent primary laparotomy (p < 0.003), development of multiple organ failure (p < 0.005), and respiratory insufficiency (p < 0.01).
  
  
  CONCLUSIONS
  Laparotomy on demand is useful in the treatment of patients with abdominal sepsis; however, the mortality is still very high.
authors.affiliation: Departamento de Gastrocirugía, tercer piso, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Av. Cuauhtémoc 330, Col. Doctores, 06725 México, DF, México.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Martínez-Ordaz
authors.forename: Roberto Manuel
authors.initials: RM
authors.lastname: Suárez-Moreno
authors.forename: Oscar Javier
authors.initials: OJ
authors.lastname: Filipez-Aguilar
authors.forename: Roberto
authors.initials: R
authors.lastname: Blanco-Benavides
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications; D007813:Laparotomy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000150:complications; D011183:Postoperative Complications; D012086:Reoperation / Q000401:mortality; D012307:Risk Factors; D018805:Sepsis / Q000601:surgery; D013530:Surgical Wound Infection / Q000150:complications