Factors effecting morbidity and mortality in secondary generalized peritonitis, prospective study

SUMMARY in this prospective study, we evaluated factors effecting morbidity and mortality in secondary generalized peritonitis. The study was done at Dicle University Hospital in 88 patients with diagnosis of secondary peritonitis and undergone an emergency operation. Ali patients were admitted in our surgical department and followed up. Pre prepared form was fîlled for ali patients and patients admitted to intensive çare unit postoperatively. Data were evaluated for age (över 65 years ör less), sex, complaint at admission, duration of complaints, findings of abdominal paracentesis, labaratory findings such as heamatocritis, white blood celi counts and platelets, presence of radiological findings such as free air in upright abdominal graphy and free intraperitoneal fluids in ultrasonograpy, time passed from the start of symptoms to operation, pre operative antibiotic prophylacsia, prophylacsia for deep vein thrombosis, at the end of the study and operative diagnosis, presence of contamination, and source of sepsis. Postoperative complications, day of staying in intensive çare unit, results of treatment, the worst scores of Meinhaim Peritonitis Index (MPI) and Acute Physiology And Chronic Health Evaluation (APACHEII) recorded at first 24 hours of operation were alil recorded. Ali patients were treated with Secondary generalized peritonitis protochol. Peptic ülser perforation, perforated appendicitis and small bowel perforations were most common reasons of secondary peritonitis. Meinhaim Peritonitis Index and APACHE II scores could be used in the follow up of critical patient although both scores were not well accepted as important and serious scores for showing mortality and morbidity. Although count of cultured bacteria was not high enough to make statistical significance, mortality rate was higher in culture positive cases. Statistical significance was found between patients less ör equel to 64 (6/70) and över 64 (7/18) years of age and age was only independent variable affecting mortality. Our mortality rate was 14.8 % and it was öne of the lowest mortality in the literatüre. Morbidity rate was 38.6% and increased day of intensive çare was affecting morbidity. Sensivity of paracentesis and ultrasonography were 60.25 % and 44.31 % respectively. As a conclusion, age was significantly increasing mortality. Sucsessfiılly made control of septic source decreased mortality. Our clinical protochol ör secondary peritonitis was sucsesfiıll. 31