Prognostic factors in typhoid perforation.
OBJECTIVE
To discuss the effect of duration of illness before perforation and time interval between perforation and surgery on the prognosis of typhoid perforation.


METHODS
Comparative study.


METHODS
Nishtar Hospital, Multan from September 2002 to September 2004.


METHODS
Seventy-two patients of typhoid perforation were included in this study. The patients were divided into three groups A, B and C according to duration of illness before perforation. In these groups, typhoid perforation occurred during 1st, 2nd and 3rd week respectively. Further patients were divided into group D, E and F according to time interval between perforation and surgery. In these groups surgery was carried out within 24 hours, 24-48 hours and after 48 hours respectively.


RESULTS
Fifty-six patients were males and 16 were females. In groups A, B and C, mortality rate was 6.6%, 13.3% and 25%, while morbidity rate was 33.3%, 55.5% and 75% respectively. There were 12, 42 and 18 patients in Group D, E and F with mortality rate of 8.33%, 11.9% and 22.2% respectively. Group D had 41.6% morbidity rate while group E and F had 71.42% and 77.7% respectively.


CONCLUSIONS
In this study, early perforation during the typhoid fever and short perforation-operation interval were good prognostic signs. So best results can be achieved by early patient's presentation and early operation.
Aziz
Muzaffar
M
Department of Surgery, Nishtar Hospital, Multan. drmuzaffaraziz@yahoo.com
Qadir
Abdul
A
Aziz
Muzammil
M
Faizullah
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery*; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000150:complications* / Q000175:diagnosis / Q000628:therapy