Background: The present study was carried out to evaluate the ASA Grading and Duration of stay among Secondary Peritonitis cases and its association with outcome in a tertiary care Hospital. Material and Methods: This study was a longitudinal, prospective study in which all patients presenting to the Department of Surgery, IGMC, Shimla over a period of twelve months from January 2021 – December 2021 and with a diagnosis of secondary peritonitis after fulfilling the inclusion and exclusion criteria were recruited. Relevant information was collected and further analysed by using IBM SPSS Statistics. Results: In the present study a total of 250 patients with diagnosis of perforation peritonitis were evaluated. Among the total Males were 205 (82%) and Females were 45 (18%). Mean age of the patients was 47.28±17.34 years with range from 18 to 87 years. Among the total, 99(39.6%) patients were age less than 40 years while 151(60.4%) patients were aged > 40 years. Among the total, 32(12.80%) were expired while 218(87.20%) were discharged after treatment. Among the total, 114(45.60%) patients were in grade 1 according American Society of Anesthesiologists (ASA) scoring system, 107 (42.80%) were in grade 2, 22(8.80%) were in grade 3 and 7(2.80%) were in grade 4. Among the total 32 patients who were expired, 2(6.3%) were in grade 1, 19(59.4%) were in grade 2, 9(28.1%) were in grade 3 and 2(6.3%) were in grade 4 while among the total 218 patients who were discharged, 112(51.4%) were in grade 1, 88(40.4%) were in grade 2, 13(6.0%) were in grade 3 and 5(2.3%) were in grade 4 according American Society of Anesthesiologists (ASA) scoring system. There was found significant association between ASA Grading and mortality. The mean duration of hospital stay among study participants was 8.99±6.07 days with range 1 to 40 days. The mean duration of hospital stay among 32 expired patients was 9.19± 8.26 days while among 218 discharged patients was 8.96±5.70 days. There was no significant association between duration of hospital stay and mortality. Conclusion: The present study concluded that most of patients of secondary peritonitis were in grade 1 of American Society of Anesthesiologists (ASA) scoring system old and there was significant association of mortality with ASA Grading but not with duration of stay in hospital.
Background: Peritonitis still poses major problem for surgeons as far as morbidity and mortality is concerned. The aim of this study is to evaluate the Socio-demographic characteristics and its association with outcome in Secondary Peritonitis cases in a tertiary care Hospital. Material and Methods: This study was a longitudinal, prospective study in which all patients presenting to the Department of Surgery, IGMC, Shimla over a period of twelve months from January 2022 – December 2022 and with a diagnosis of secondary peritonitis after fulfilling the inclusion and exclusion criteria were recruited. Relevant information was collected and further analysed by using IBM SPSS Statistics. Results: In this study, a total of 250 patients with diagnosis of perforation peritonitis were evaluated. Among the total Males were 205 (82%) and Females were 45 (18%). Mean age of the patients was 47.28±17.34 years with range from 18 to 87 years. Among the total, 99 (39.6%) patients were age less than 40 years while 151 (60.4%) patients were aged > 40 years. Among the total, 32 (12.80%) were expired while 218 (87.20%) were discharged after treatment. Among the total 205 males, 19 (9.3%) were expired and 186 (90.7%) were discharged while among total 45 females 13 (28.9%) were expired and 32 (71.1%) were discharged. There was significant difference in mortality among males and females. Mean age of 32 expired patients was 59.16±13.32 years while mean age of 218 discharged patients was 45.49± 16.96 years. There was significant difference in mortality according to age. Among the total 205 Males mean BMI was 21.93±3.00 while among the total 45 females mean BMI was 20.68±2.46. Among the total 32 expired patients mean BMI was 22.69±3.54 while among the total 218 discharged patients mean BMI was 21.76 ±2.80. There was no significant difference in mortality according to BMI. Conclusion: In the present study maximum patients of secondary peritonitis were males and less than 40 years old. There was significant association of mortality with gender and age group.
Background: The present study was carried out to evaluate the serum lactate, pH and procalcitonin level as a prognostic indicator for mortality among secondary peritonitis patients. Material and Methods: This cross sectional study was conducted by Department of Surgery, IGMC, Shimla over a period of twelve months from January 2021 – December 2021 among patients with a diagnosis of secondary peritonitis after fulfilling the inclusion and exclusion criteria. Relevant information was collected and further analysed by using IBM SPSS Statistics. Results: A total of 250 individuals with a diagnosis of perforation peritonitis were assessed. Of the total, 32 (12.80%) passed away while 218 (87.20%) were discharged. Mean Pre (AL1), Postoperative (AL24) lactate level and Absolute lactate clearance (AL1 - AL24) was 2.48±1.42 and 1.74±1.52 and 0.74 mmol/L respectively. There was significant difference in the AL1 and AL24. Mean AL1 in expired patients was 3.78±2.24 mmol/L while among discharged patients it was 2.29 ±1.15 mmol/L and its increased level was significantly associated with mortality. The mean AL24 in expired patients was 3.67±3.18 mmol/L while among discharged patients it was 1.45 ±0.76 mmol/L and its increased level was significantly associated with mortality. The mean AL1 - AL24 in expired patients was 0.11±2.79 mmol/L while among discharged patients it was 0.84 ±1.1- mmol/L and its decreased level was significantly associated with mortality. Mean Pre (pH1), Postoperative (pH24) pH level and Procalcitonin was 7.33±0.10 and 7.35±0.11 and 0.88±0.80 ng/ml respectively. Mean pH1 in expired patients was 7.16±0.09 while among discharged patients it was 7.36 ±0.08 and its decreased level was significantly associated with mortality. The mean pH24 in expired patients was 7.17±0.13 mmol/L while among discharged patients it was 7.38 ±0.07 and its decreased level was significantly associated with mortality. The mean Procalcitonin level in expired patients was 2.58 ±1.26 ng/ml while among discharged patients it was 0.63 ±0.18 ng/ml and its increased level was significantly associated with mortality. Conclusion: The study concluded that increased Pre (AL1), Postoperative (AL24) lactate and Procalcitonin level while decreased Absolute lactate clearance (AL1 - AL24) , Pre (pH1) and Postoperative (pH24) pH level was significantly associated with mortality.
Background: In the majority of general surgical units around the world, Secondary Peritonitis is the common surgical emergency and has high risk of morbidity and mortality. The present study was done to evaluate the surgical management among Secondary Peritonitis cases in a tertiary care Hospital. Material and Methods: This cross sectional study was conducted by Department of Surgery, IGMC, Shimla over a period of twelve months from January 2021 – December 2021 among patients with a diagnosis of secondary peritonitis after fulfilling the inclusion and exclusion criteria. Relevant information was collected and further analysed by using IBM SPSS Statistics. Results: A total of 250 individuals with a diagnosis of perforation peritonitis were assessed in the current study. Males made up 205 (82%) of the total while females made up 45 (18%). The patients' average age was 47.28 17.34 years, ranging from 18 to 87. In the study, 99 (39.6%) of the total patients were under the age of 40, while 151 (60.4%) were beyond the age of 40. Of the total, 32 (12.80%) passed away while 218 (87.20%) were discharged after receiving treatment. In the present study, most of patients 89 (35.6%) of secondary peritonitis were managed by Cellan jones repair followed by Loop ileostomy in 43 (17.2%) patients End ileostomy in 27 (10.8%) patients and rest by other procedures. Conclusion: The study concluded that most of patients of secondary peritonitis were managed by Cellan jones repair followed by Loop ileostomy and End ileostomy.
Background: The present study was carried out to evaluate the Site of Perforation among Secondary Peritonitis cases and its association with outcome in a tertiary care Hospital. Material and Methods: This cross sectional study was conducted by Department of Surgery, IGMC, Shimla over a period of twelve months from January 2021 – December 2021 among patients with a diagnosis of secondary peritonitis after fulfilling the inclusion and exclusion criteria. Relevant information was collected and further analysed by using IBM SPSS Statistics. Results: A total of 250 individuals with a diagnosis of perforation peritonitis were assessed in the current study. Males made up 205 (82%) of the total while females made up 45 (18%). The patients' average age was 47.28 17.34 years, ranging from 18 to 87. In the study, 99 (39.6%) of the total patients were under the age of 40, while 151 (60.4%) were beyond the age of 40. Of the total, 32 (12.80%) passed away while 218 (87.20%) were discharged after receiving treatment. The Most common cause was Duodenal perforation among 91 patients (36.4%), Gastric perforation among 83 patients (33.2%), Ileal perforation among 32 patients (12.8%), Jejunal perforation among 16 patients (6.4%) and Other among 28 patients (11.2%). Among the patients who expired due to Secondary Peritonitis, maximum 12(37.5%) had Gastric Perforation followed by Duodenal Perforation in 9 (28.1%) patients. Conclusion: The study concluded that most of patients of secondary peritonitis had Duodenal perforation followed by Gastric perforation. The most common type of perforation among patients who died from secondary peritonitis was gastric followed by duodenal.
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