Department of General Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Infection. 2010 Aug;38(4):255-60. doi: 10.1007/s15010-010-0021-4.
We investigated the relationship between the prognostic factors of postoperative peritonitis and mortality.
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.
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.
Delaying relaparotomy for more than 24 h and presence of organ failure result in higher mortality.
我们研究了术后腹膜炎的预后因素与死亡率之间的关系。
回顾性收集了 1991 年至 2001 年我院 56 例因术后继发性腹膜炎再次手术患者的数据。记录人口统计学特征、合并症、恶性肿瘤、器官衰竭、首次手术的类型和时机、术中发现、术后腹膜炎的病因、再次剖腹手术的次数、源头控制失败、曼海姆腹膜炎指数(MPI)和死亡率。还记录了首次手术和再次剖腹手术之间以及症状出现和第二次手术之间的时间间隔。
总死亡率为 32%(n=18)。器官衰竭(p=0.001)、症状出现与第二次手术之间的时间间隔(p=0.046)、腹膜炎严重程度(p=0.035)、源头控制失败(p=0.047)和 MPI 评分(p=0.032)在单因素分析中与术后腹膜炎的死亡率显著相关。MPI 评分>30 者死亡率更高。
再次剖腹手术延迟超过 24 小时和存在器官衰竭会导致更高的死亡率。