Secondary Peritonitis Prognosis Assessment

Czech version

Authors: P. Novák; V. Liška; T. Kural; M. Brabec; J. Kulda; V. Třeška
Authors‘ workplace: Chirurgická klinika LF UK a FN v Plzni, přednosta: prof. MUDr. Vladislav Třeška, DrSc.
Published in: Rozhl. Chir., 2011, roč. 90, č. 10, s. 543-548.
Category: Monothematic special - Original

Overview

Introduction:
Secondary peritonitis is a severe disease with high mortality and morbidity. In the last 20 years the results of treatment of this disease have improved markedly.

Aim of the study:
To determine statistically significant risk factors for mortality in patients with severe secondary peritonitis.

Material and methods:
We studied in retrospective analysis the cohort of patients treated at our clinic in the period 2005–2010. 65 patients (38 men and 27 women) with an average age of 60.7 years were included. 27 patients died (41.5%). The average age of the died patients was 72 years. The average value of APACHE II was 20.77, which corresponds to the prediction of lethality 41.8%. The average value of the SOFA score was 11.87.

Results:
The performed statistical analysis showed age over 65 years, bronchopneumonia, obesity, ischemic heart disease, artificial ventilation over 6 days and circulatory support over 10 days as statistically significant independent factors for mortality. Patients older than 65 years had 8.9 times greater risk of death. In the case of bronchopneumonia was the risk 4.8 times higher. Obesity increased the risk of death 3.1 times and ischemic heart disease 2.4 times. In the case of mechanical ventilation for more than 6 days and circulatory support for more than 10 days, these increased the risk of death 4.1 times respectively 4.3 times.

Discussion:
The benefit for determining the prognosis secondary peritonitis is the use of scoring systems. It was also shown that the basic clinical data may have the same benefit for predicting the prognosis of patients as a sophisticated scoring systems.

Conclusion:
The performed retrospective analysis age over 65 years, bronchopneumonia, obesity, artificial ventilation and circulatory support as statistically significant independent factors for prediction of poor survival. These basic clinical factors correlated with scoring systems APACHE II a SOFA.

Key words:
severe secondary peritonitis – surgical treatment – scoring systems – prediction of survival

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