Ann Coloproctol.  2016 Dec;32(6):221-227. 10.3393/ac.2016.32.6.221.

Predictors of Morbidity and Mortality After Surgery for Intestinal Perforation

• Shin R
• Lee SM
• Sohn B
• Lee DW
• Song I
• Chai YJ
• Lee HW
• Ahn HS
• Jung IM
• Chung JK
• Heo SC

• KMID: 2366060
• DOI: http://doi.org/10.3393/ac.2016.32.6.221

Abstract

PURPOSE
An intestinal perforation is a rare condition, but has a high mortality rate, even after immediate surgical intervention. The clinical predictors of postoperative morbidity and mortality are still not well established, so this study attempted to identify risk factors for postoperative morbidity and mortality after surgery for an intestinal perforation.
METHODS
We retrospectively analyzed the cases of 117 patients who underwent surgery for an intestinal perforation at a single institution in Korea from November 2008 to June 2014. Factors related with postoperative mortality at 1 month and other postoperative complications were investigated.
RESULTS
The mean age of enrolled patients was 66.0 ± 15.8 years and 66% of the patients were male. Fifteen patients (13%) died within 1 month after surgical treatment. Univariate analysis indicated that patient-related factors associated with mortality were low systolic and diastolic blood pressure, low serum albumin, low serum protein, low total cholesterol, and high blood urea nitrogen; the surgery-related factor associated with mortality was feculent ascites. Multivariate analysis using a logistic regression indicated that low systolic blood pressure and feculent ascites independently increased the risk for mortality; postoperative complications were more likely in both females and those with low estimated glomerular filtration rates and elevated serum C-reactive protein levels.
CONCLUSION
Various factors were associated with postoperative clinical outcomes of patients with an intestinal perforation. Morbidity and mortality following an intestinal perforation were greater in patients with unstable initial vital signs, poor nutritional status, and feculent ascites.

Keyword

Intestinal perforations; Postoperative mortality; Postoperative complications; Ascites

MeSH Terms

Ascites
Blood Pressure
Blood Urea Nitrogen
C-Reactive Protein
Cholesterol
Female
Glomerular Filtration Rate
Humans
Hypotension
Intestinal Perforation*
Korea
Logistic Models
Male
Mortality*
Multivariate Analysis
Nutritional Status
Postoperative Complications
Retrospective Studies
Risk Factors
Serum Albumin
Vital Signs
C-Reactive Protein
Cholesterol
Serum Albumin