title: Prognostic factors in gastrointestinal perforation.
abstract: OBJECTIVE
  Postoperative complications associated with gastrointestinal (GI) perforation may lead to a poor prognosis. The goal of the study was to identify factors required for the establishment of appropriate perioperative procedures in such cases.
  
  
  METHODS
  The subjects were 51 patients with GI perforation treated from July 2007 to June 2008 in six hospitals in the Minamikawachi district.
  
  
  RESULTS
  The perforation sites were the large intestine in 22 cases, small intestine in 15, stomach in 7 and duodenum in 7. Postoperative complications developed in 25 cases (49%), including infection in 20 and respiratory dysfunction in 13. Hospital mortality was 25% and the major causes of death were infection and respiratory dysfunction. The mortality was 52% and 0% in patients with and without postoperative complications, respectively. The mortality was 69% in the 13 patients with postoperative respiratory dysfunction compared to 11% for patients without respiratory dysfunction. Of the 7 patients with large intestine perforation, 4 were treated with sivelestat sodium. These 4 patients had a high mean SOFA score (11.5±1.3), but 2 out of 4 survived.
  
  
  CONCLUSIONS
  Postoperative complications occurred in approximately half of the patients with GI perforation and were associated with a poor prognosis. Prevention of respiratory dysfunction is particularly important for an improvement of outcome.
authors.affiliation: Department of Surgery, Kinki University School of Medicine, Osaka-sayama, Japan. okuno@surg.med.kindai.ac.jp
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Okuno
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishibashi
authors.forename: Hironori
authors.initials: H
authors.lastname: Shigeoka
authors.forename: Akira
authors.initials: A
authors.lastname: Hayashibe
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tsubakihara
mesh_terms: D005260:Female; D005998:Glycine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007416:Intestinal Perforation / Q000401:mortality* / Q000601:surgery*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D015996:Survival Rate
chemical_list: D015842:Serine Proteinase Inhibitors; D013449:Sulfonamides; C069195:sivelestat; D005998:Glycine