Title
Morbidity and mortality risk factors in patients with ileal typhoid perforation
Other title
Factores de riesgo de morbilidad y mortalidad en pacientes con perforación tífica ileal.
Date Issued
01 January 2006
Access level
metadata only access
Resource Type
journal article
Abstract
OBJECTIVES: To determine the risk factors, morbidity and mortality rates and the types of postoperative complications in patients undergoing surgery for ileal typhoid perforation. MATERIAL AND METHODS: This retrospective study evaluated 126 patients with anatomohistological diagnosis of ileal typhoid perforation treated at the Belen Hospital, Trujillo, Peru between 1966 and 2000. RESULTS: The average age of the total series was of 21.39 + 13.4 years (range 1 to 57 years); of which, 97 (76.98%) were male and 29 (23.02%) women (proportion M:F, 3.3:1). By means of univariate analysis, the morbidity was related with the absence of previous medical treatment (p = 0.035). The mortality was associated to time of perforation exceeding 48 hours (p = 00001); digestive hemorrhages (p = 0.003), leukocyte count (p = 0.021) fecaloid peritoneal secretion (p = 0.007) number of perforations (p = 0.001) and the surgical technique, that presented major mortality was the resection and ileostomy (48.3%; p = 0.001). The group of patients that presented post-surgical complications was 80.16%, of which 19.8% of them died. The most frequent complications were wound infections (67.3%) and sepsis (27.7%). In the multivariate analysis two parameters were evidenced in relation to morbidity: previous medical treatment (p < 0.05; OR = 2.9) and number of perforations (p = 0.01; OR = 6.4). With regard to mortality the significant statistical parameters were: low digestive hemorrhages (p = 0.02; OR = 11.4) leukocyte count (p < 0.008; OR = 7.9) type of operation (p = 0.03; OR = 1.8) peritoneal secretion (p < 0.04; OR = 3.02) and number of perforations (p = 0.008; OR = 4.6). CONCLUSIONS: The risk factors identified in the present series can be useful to elaborate a risk scale to predict a small, moderate or greater probability of complications and postoperative mortality.
Start page
25
End page
33
Volume
26
Issue
1
Language
Spanish
OCDE Knowledge area
Gastroenterología, Hepatología
Scopus EID
2-s2.0-33747109203
PubMed ID
Source
Revista de gastroenterología del Perú : órgano oficial de la Sociedad de Gastroenterología del Perú
ISSN of the container
10225129
Sources of information: Directorio de Producción Científica Scopus