title: Relaparotomies: Why is Mortality Higher?
abstract: BACKGROUND
  Relaparotomy is sometimes required for complications that develop after abdominal surgery, but it is associated with high mortality. We aimed to investigate the independent risk factors related to mortality in patients that undergo relaparotomies.
  
  
  METHODS
  One hundred and fourteen patients who had relaparatomies were evaluated. Risk factors studied were patient characteristics, cause of the first operation, condition of the first operation, systemic diseases, presence of peritonitis, relaparotomy interval, cause of relaparatomy, APACHE II score, transfused blood units, number of relaparatomies, length of hospital stay, and mortality. In order to determine the independent risk factors, we carried out multivariate logistic regression analysis.
  
  
  RESULTS
  There were 75 male and 39 female patients with a mean age of 46.06 ± 19.98 (15-84). The most common reasons for relaparotomy were leakage from intestinal primary repair or anastomosis (29.8%). Mortality developed in 55 (48.2%) patients undergoing relaparatomy. Intestinal necrosis (p = 0038) and intraabdominal sepsis (p = 0.027) were found to be risk factors in mortality. In multivariate logistic regression analysis, advanced age (OR 0.966, p = 0. 0.017) and APACHE II score ≥ 20 (OR 0.137, p < 0.0001) were found to be independent risk factors affecting mortality.
  
  
  CONCLUSIONS
  Advanced age and APACHE II score ≥ 20 were found to be independent risk factors affecting relaparotomy-related mortality.
authors.affiliation: Department of General Surgery, Dicle University, Diyarbakir, Turkey. egedik@dicle.edu.tr.|Department of General Surgery, Dicle University, 21280, Diyarbakir, Turkey. egedik@dicle.edu.tr.
authors.forename: Ercan
authors.initials: E
authors.lastname: Gedik
authors.affiliation: Department of General Surgery, Dicle University, Diyarbakir, Turkey.
authors.forename: Kazým
authors.initials: K
authors.lastname: Söylemez
authors.affiliation: Department of General Surgery, Dicle University, Diyarbakir, Turkey.
authors.forename: Sadullah
authors.initials: S
authors.lastname: Girgin
authors.affiliation: Department of General Surgery, Dicle University, Diyarbakir, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Uysal
authors.affiliation: Department of General Surgery, Dicle University, Diyarbakir, Turkey.
authors.forename: Ýbrahim
authors.initials: Ý
authors.lastname: Taçyýldýz
keywords: Mortality; Relaparotomy; Risk factors
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