Outcome and prognostic factors of morbidity and mortality in perforated sigmoid diverticulitis.
The aim of this study was to assess the outcomes after treatment of patients with this condition and to identify prognostic factors of morbidity and mortality. From 1986 to 2005, the charts of 114 consecutive patients who were treated for perforated sigmoid diverticulitis were retrospectively reviewed. Thirty-three patients (28.9%) were treated conservatively, and 81 (71.1%) underwent surgery. Postoperative major morbidity and mortality rates were 35.8% and 6.2%, respectively. Age > 70 years, female sex, associated diseases, low serum albumin level, high American Society of Anesthesiologists class, and Mannheim Peritonitis Index score of 21 or more were factors linked with a poor outcome. Perforated diverticulitis carries substantial morbidity and occasional mortality. To achieve improvements in outcomes, the surgical procedure should be chosen on the basis of the presence of prognostic factors. Moreover, intensive treatment after surgery in patients with risk factors is recommended.
Alvarez
José A
JA
Service of General Surgery, Hospital San Agustín, Avilés, Spain. josealvar@telecable.es
Baldonedo
Ricardo F
RF
Bear
Isabel G
IG
Otero
Jorge
J
Pire
Gerardo
G
Alvarez
Paloma
P
Jorge
José I
JI
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D012809:Colon, Sigmoid / Q000473:pathology* / Q000601:surgery*; D015897:Comorbidity; D004239:Diverticulitis, Colonic / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D018709:Statistics, Nonparametric; D016896:Treatment Outcome