title: Sigmoid colon torsion: mortality and relevant risk factors.
abstract: BACKGROUND
  Sigmoid volvulus is an important acute intestinal obstruction, leading to high mortality and requiring urgent operation. The purpose of this study is to analyze risk factors for mortality in patients that were operated on due to sigmoid volvulus at our Department.
  
  
  METHODS
  The retrospective study included 158 patients, who were operated on due to sigmoid volvulus between January 1994-December 2010, in terms of age, gender, complaints at admission, physical signs, period of symptoms before admission, associated diseases, laboratory and radiological parameters, hospital stay, morbidity, and mortality.
  
  
  RESULTS
  The study consisted of 135 men (85.4%) and 23 women (14.6%), with a mean age of 62.54 years. Cardiovascular disease and respiratory disease were present in 34 (21.5%) and 42 (26.6%) patients, respectively. Urgent operation was undertaken in 125, while 33 received elective surgery. Abdominal distension and pain was evident in all the patients. Generalized tenderness was detected in 58.2%, while 70.9% had hyperactive bowel sound with tympanism. Plain radiograph revealed an impression of "omega ans" in all patients, while free air was detected in 11.4% of them. Risk factors for mortality included age (p = 0.008), delayed admission (p = 0.001), cardiovascular and respiratory diseases (p = 0.001), fluid-electrolyte imbalance (p =0.001), presence of necrosis (p = 0.001), and major contamination (p = 0.001). Wound infection and intraabdominal abscess were more common in patients that developed mortality (p = 0.001 and p = 0.002).
  
  
  CONCLUSIONS
  Complications like wound infection and intraabdominal abscess are more frequent in the patients with the risk of mortality. Delayed admission results in higher risk of mortality. Mortality rates can be reduced by early admission, preoperative intensive resuscitation, suitable antibiotics, and emergent and viable surgery.
authors: Department of General Surgery, Dicle University, Diyarbakir, Turkey. draonder@gmail.com
authors: A
authors: A
authors: Onder
authors: M
authors: M
authors: Kapan
authors: Z
authors: Z
authors: Arikanoglu
authors: Y
authors: Y
authors: Palanci
authors: M
authors: M
authors: Gumus
authors: I
authors: I
authors: Aliosmanoglu
authors: M
authors: M
authors: Aldemir
mesh_terms: D018784:Abdominal Abscess / Q000401:mortality; D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000401:mortality*; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006801:Humans; D045822:Intestinal Volvulus / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D013530:Surgical Wound Infection / Q000401:mortality; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D055815:Young Adult