title: [Hospital mortality after emergency surgery for perforated diverticulitis].
abstract: OBJECTIVE
  To assess which factors predict in-hospital mortality after emergency surgery for acute perforated diverticulitis.
  
  
  METHODS
  Multicenter retrospective study.
  
  
  METHODS
  From 1995-2005 a total of 291 patients underwent surgery to treat perforated diverticulitis in five teaching hospitals in Rotterdam, the Netherlands. The relation to postoperative mortality of patient-related risk factors such as age, gender and classification according to the American Society of Anesthesiologists (ASA); disease severity factors such as Hinchey score and Mannheim peritonitis index (MPI); surgery-related risk factors, such as type of surgery, e.g. Hartmann’s procedure (HP) or resection with primary anastomosis; surgeon, and time of operation were evaluated using multivariate analysis.
  
  
  RESULTS
  The total postoperative in-hospital mortality was 29%. HP was performed 211 times and primary anastomosis was performed 75 times. HP was significantly more frequently performed in patients with higher values of age, ASA, Hinchey and MPI (all: p < 0.01). Multiple logistic regression analysis showed that age, ASA classification, Hinchey score, MPI and the absence of a specialist gastrointestinal surgeon during surgery, were important prognostic factors of mortality. Surgical technique was not related to postoperative mortality (adjusted odds ratio for mortality (HP versus primary anastomosis): 1.3; 95% CI: 0.6-2.9; p = 0.54).
  
  
  CONCLUSIONS
  The type of surgery did not appear to be a risk factor for high postoperative mortality. As well as patient-related risk factors, including age, ASA and severity of disease scores, such as Hinchey score and MPI, the absence of a specialist gastrointestinal surgeon during surgery was found to be a factor associated with high mortality risk.
authors.forename: Jefrey
authors.initials: J
authors.lastname: Vermeulen
authors.forename: Martijn P
authors.initials: MP
authors.lastname: Gosselink
authors.forename: Wim C J
authors.initials: WC
authors.lastname: Hop
authors.forename: Johan F
authors.initials: JF
authors.lastname: Lange
authors.forename: Peter-Paul L O
authors.initials: PP
authors.lastname: Coene
authors.forename: Erwin
authors.initials: E
authors.lastname: van der Harst
authors.forename: Wilbo F
authors.initials: WF
authors.lastname: Weidema
authors.forename: Guido H H
authors.initials: GH
authors.lastname: Mannaerts
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000401:mortality / Q000706:statistics & numerical data; D013505:Digestive System Surgical Procedures / Q000401:mortality; D004238:Diverticulitis / Q000401:mortality* / Q000601:surgery; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007416:Intestinal Perforation / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult