Preoperative Predictors of Mortality in Adult Patients with Gastric and Small Bowel Perforation
Keywords:
Peritonitis, Perforation, Predictors, MortalityAbstract
Background: Perforation peritonitis is one of the most serious conditions encountered by a surgeon in the emergency. As a result, it becomes important to diagnose this condition early and intervene at the earliest. Higher mortality rates have been implicated with this disease as a result of which understanding of preoperative predictors of mortality becomes necessary to lower down these rates. Methods: A prospective study of 60 cases diagnosed with perforation peritonitis who underwent laparotomy was undertaken at Government Medical College and Rajindra Hospital, Patiala and data was collected in terms of age, gender, signs and symptoms, presentation to hospital, surgery timing and hematological investigations and was evaluated. Results: Distribution of cases showed a bimodal pattern where both younger and middle age group patients were present, majority of which were males (53/60). Ileal perforation was the most common intraoperative finding in the younger population whereas 50% (7/14) of cases in the middle age group had gastric perforation. 41/60 patients presented within 72 hrs from the onset of symptoms out of which only 3 patients died. 53/60 patients underwent exploratory laparotomy within 24hrs of admission. Higher mortality was observed in patients having raised total leucocyte count(TLC), deranged renal function tests (RFT) and dyselectrolytemia. Conclusion: Through our study we aimed to evaluate the importance of certain preoperative factors that can play a role in predicting mortality in patients of gastric and small bowel perforation.
Keywords : Peritonitis, Perforation, Predictors, Mortality
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References
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