Predictors of Morbidity and Mortality after Surgery for Small Intestinal Perforation

Résumé fourni par la source

Background: A frequent surgical emergency with significant morbidity and death is small intestinal perforation. It hasbeen shown that a variety of factors affect how well surgical patients fare.Objectives: To determine straightforward and understandable prognostic indicators related to patients and surgery thatare linked to postoperative morbidity and death in patients having surgery to repair an intestinal perforation.Patients and Methods: This was a prospective study included 50 cases of small intestinal perforation who were subjected to history taking, clinical examination and both laboratory and radiological investigations. All cases were prepared for surgery and surgical intervention was performed. After discharge, patients were followed through clinical and radiological assessment. Operative and postoperative data were recorded.Results: Age, leukocytosis, hyperglycemia, hypoalbuminemia, arterial blood gases abnormalities (ABG), history of(multiple diseases, diabetes mellitus (DM), hypertension (HTN), cardiac disease, hepatic disease), an ASA score ≥3,shock on presentation, delay between symptoms onset and operation, prolonged operative time, ICU admission, bloodtransfusion and perforation cause were significant predictive factors for post-operative mortality. Same factors (excepthepatic disease history) along with specimen pathology and jejunal perforation were significant predictors for postoperative morbidity.Conclusions: Among patients underwent surgery for intestinal perforation age, leukocytosis, hypoalbuminemia, RBS,ABG abnormalities, history of (multiple diseases, DM, HTN, cardiac disease), ASA score, shock on presentation, timeinterval between symptoms and admission, operative time, jejunal perforation, perforation cause, perioperative bloodtransfusion, ICU admission and pathology results were significant predictors for post-operative morbidities. Fore mortality, the same predictors apply with addition to hepatic disease and exclusion of pathology result and jejunal perforation.

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