Prognostic factors of the mortality of postoperative intraabdominal infections.
OBJECTIVE
We investigated the relationship between the prognostic factors of postoperative peritonitis and mortality.


METHODS
Data from 56 patients re-operated for postoperative secondary peritonitis in our hospital between 1991 and 2001 were collected retrospectively. Demographic features, comorbidity, malignancy, organ failure, type and timing of the primary operation, intraoperative findings, etiology of postoperative peritonitis, number of relaparotomies, source control failure, Mannheim peritonitis index (MPI), and mortality were noted. The time intervals between the first operation and relaparotomy, and between symptom onset and the second operation were also noted.


RESULTS
The overall mortality rate was 32% (n = 18). Organ failure (p = 0.001), time elapse between symptoms and the second operation (p = 0.046), severity of peritonitis (p = 0.035), source control failure (0.047), and MPI scores (p = 0.032) were significantly related with the mortality of postoperative peritonitis in a univariate analysis. MPI score >30 had a higher mortality rate.


CONCLUSIONS
Delaying relaparotomy for more than 24 h and presence of organ failure result in higher mortality.
Torer
N
N
Department of General Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey. ntorer@yahoo.com.tr
Yorganci
K
K
Elker
D
D
Sayek
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D004066:Digestive System Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006801:Humans; D007813:Laparotomy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*
Langenbecks Arch Chir. 1992;377(5):305-13
1405957
Langenbecks Arch Chir. 1992;377(4):237-43
1508014
Can J Surg. 1999 Apr;42(2):122-6
10223073
Surg Infect (Larchmt). 2007 Feb;8(1):63-72
17381398
World J Surg. 2003 Apr;27(4):379-84
12658477
Langenbecks Arch Surg. 2002 Apr;387(1):1-7
11981677
Eur J Surg. 1993 May;159(5):267-74
8103360
Hepatogastroenterology. 1997 Jul-Aug;44(16):937-46
9261581
Fortschr Med. 1982 Apr 8;100(13):560-4
7095686
Br J Surg. 2002 Dec;89(12):1516-24
12445059
Arch Surg. 1996 Jun;131(6):641-5
8645072
Chirurg. 1987 Feb;58(2):84-92
3568820
Ann Surg. 1996 Jul;224(1):10-8
8678610
Infection. 1998 Sep-Oct;26(5):335-41
9795802
Crit Care Med. 2004 Nov;32(11 Suppl):S513-26
15542959
Eur J Surg. 1996 Aug;162(8):619-25
8891619
Hepatogastroenterology. 2001 Jan-Feb;48(37):147-51
11268952
Br J Surg. 2006 May;93(5):616-22
16607684
J Gastrointest Surg. 2009 Jul;13(7):1358-67
19352781
Crit Care Med. 1985 Oct;13(10):818-29
3928249
Arch Surg. 1985 Oct;120(10):1109-15
4038052
Langenbecks Arch Chir. 1994;379(3):152-8
8052056