Staged abdominal repair in the treatment of intra-abdominal infection: analysis of 102 patients

Abstract

Surgical treatment of intra-abdominal infections remains a challenge for the surgeon. Staged abdominal repair is being commonly used in patients with intra-abdominal infections. This study presents our experience with staged abdominal repair and analyzes factors affecting mortality. A total of 102 patients who underwent staged abdominal repair procedures for intra-abdominal infections during a 12-year period were retrospectively reviewed. The effects of several risk factors on mortality were evaluated. The investigated risk factors included age, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, number of operations prior to staged abdominal repair, number of repeat laparotomies, anatomic origin of infection, and etiology of intra-abdominal infections. The overall mortality rate was 40% (41/102). The mean number of operations prior to staged abdominal repair (0.72 +/- 0.1 in survivors vs. 1.37 +/- 0.21 in nonsurvivors), age (24.5% mortality under 55 years vs. 53.6% mortality between 55 and 65 years vs. 75% mortality over 65 years), and APACHE II score (13.4 +/- 3.4 in survivors vs. 20.3 +/- 6.64 in nonsurvivors) were correlated with mortality rates (P < 0.05). Our results showed that the physiologic status of patients, severity of sepsis, and decision time for staged abdominal repair were all associated with higher mortality.