[Morbidity and mortality risk factors in patients with ileal typhoid perforation].
OBJECTIVE
To determine the risk factors, morbidity and mortality rates and the types of postoperative complications in patients undergoing surgery for ileal typhoid perforation.


METHODS
This retrospective study evaluated 126 patients with anatomohistological diagnosis of ileal typhoid perforation treated at the Belen Hospital, Trujillo, Peru between 1966 and 2000.


RESULTS
The average age of the total series was of 21.39 + 13.4 years (range 1 to 57 years); of which, 97 (76.98%) were male and 29 (23.02%) women (proportion M:F, 3.3:1). By means of univariate analysis, the morbidity was related with the absence of previous medical treatment (p = 0.035). The mortality was associated to time of perforation exceeding 48 hours (p = 00001); digestive hemorrhages (p = 0.003), leukocyte count (p = 0.021) fecaloid peritoneal secretion (p = 0.007) number of perforations (p = 0.001) and the surgical technique, that presented major mortality was the resection and ileostomy (48.3%; p = 0.001). The group of patients that presented post-surgical complications was 80.16%, of which 19.8% of them died. The most frequent complications were wound infections (67.3%) and sepsis (27.7%). In the multivariate analysis two parameters were evidenced in relation to morbidity: previous medical treatment (p < 0.05; OR = 2.9) and number of perforations (p = 0.01; OR = 6.4). With regard to mortality the significant statistical parameters were: low digestive hemorrhages (p = 0.02; OR = 11.4) leukocyte count (p < 0.008; OR = 7.9) type of operation (p = 0.03; OR = 1.8) peritoneal secretion (p < 0.04; OR = 3.02) and number of perforations (p = 0.008; OR = 4.6).


CONCLUSIONS
The risk factors identified in the present series can be useful to elaborate a risk scale to predict a small, moderate or greater probability of complications and postoperative mortality.
Honorio-Horna
Carlos Enrique
CE
Facultad de Medicina, Universidad Privada Antenor Orrego de Trujillo.
Díaz-Plasencia
Juan
J
Yan-Quiroz
Edgar
E
Burgos-Chavez
Othoniel
O
Ramos-Domínguez
Claudia Paola
CP
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications* / Q000382:microbiology / Q000401:mortality* / Q000601:surgery; D007223:Infant; D007416:Intestinal Perforation / Q000150:complications* / Q000382:microbiology / Q000401:mortality* / Q000601:surgery; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014435:Typhoid Fever / Q000150:complications* / Q000401:mortality* / Q000601:surgery