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. 2016 Dec;32(6):221-227.
doi: 10.3393/ac.2016.32.6.221. Epub 2016 Dec 31.

Predictors of Morbidity and Mortality After Surgery for Intestinal Perforation

Rumi Shin  1 , Sang Mok Lee  1 , Beonghoon Sohn  1 , Dong Woon Lee  2 , Inho Song  2 , Young Jun Chai  1 , Hae Won Lee  1 , Hye Seong Ahn  1 , In Mok Jung  1 , Jung Kee Chung  1 , Seung Chul Heo  1
Affiliations

Predictors of Morbidity and Mortality After Surgery for Intestinal Perforation

Rumi Shin et al. Ann Coloproctol. 2016 Dec.

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.

Keywords: Ascites; Intestinal perforations; Postoperative complications; Postoperative mortality.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Surgical methods used to treat patients with intestinal perforations (n = 117). R&A, resection and anastomosis.
Fig. 2
Fig. 2. Kaplan-Meier analysis of 30-day mortality in patients with feculent ascites and nonfeculent ascites after surgery for an intestinal perforation. A log-rank test indicated significantly greater mortality in patients with feculent ascites.
Fig. 3
Fig. 3. Incidences and mortality rates of postoperative complications after surgery for an intestinal perforation.
See this image and copyright information in PMC

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