Effect of Early Surgery on Outcome In Perforation Peritonitis

Bhandari, Tika Ram; Poudel, Rajesh; Chandra, Kailash

doi:10.3126/jucms.v5i1.19048

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…A patient with pre-renal acute kidney injury and an altered level of consciousness from shock may have these parameters corrected with adequate resuscitation before surgery and is expected to have a better postoperative outcome than those patients proceeding to surgery with markedly deranged APS. Literature has shown that delayed presentation is a risk factor for poorer outcomes, independent of APACHE II points at admission [ 29 , 30 ]. Therefore, a one-time APACHE II score at admission may not completely predict the likely outcome of care in all patients, particularly when there are delays before surgery.…”

Section: Discussionmentioning

confidence: 99%

Predictive Role of Acute Physiology and Chronic Health Evaluation II (APACHE II) in Patients With Peritonitis at the National Hospital Abuja

Situ,

Badejo,

Gwaram

2024

Cureus

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Background: A validated tool may facilitate assessing the severity of peritonitis among surgical patients. This study evaluates the predictive role of Acute Physiology and Chronic Health Evaluation II (APACHE II) in the surgical outcomes of patients managed for peritonitis in Abuja. Method: This is a prospective study of consecutive adult patients managed for peritonitis by the general surgery unit of National Hospital Abuja (NHA) over a 19-month period (September 2020 through March 2022). Patient characteristics and treatment outcomes were recorded in a structured proforma and analyzed using SPSS Statistics version 25 (IBM Corp., Released 2017; IBM SPSS Statistics for Windows, Version 25.0; Armonk, NY: IBM Corp.). The accuracy, sensitivity, specificity, and threshold of APACHE II were derived from the receiver operating characteristic (ROC) curve analysis and its coordinates. Results: There were 54 patients with peritonitis during the study period, with a male-to-female ratio of 2.6:1. This study's mortality and morbidity rates were 13.0% and 63.0%, respectively. The APACHE II score at admission was positively correlated with the likelihood of postoperative mortality, morbidity, number of postoperative complications, ICU admission, and length of hospital admission. The average APACHE II score of patients in this study was 7.1±5.2. APACHE II best-predicted mortality by the ROC curve at a threshold point of 9 (sensitivity of 85.7%, specificity of 70.2%, the accuracy of 86.8%, P-value 0.002). At a threshold score of 6, APACHE II was significantly associated with the occurrence of postoperative morbidity (sensitivity of 74.3%, specificity of 73.7%, accuracy of 75.2%, P-value = 0.043). Conclusions: This study confirms that the APACHE II score at admission can predict the outcome of surgery within the first 30 days post-surgery among adult patients who had peritonitis at NHA.

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Section: Discussionmentioning

confidence: 99%

Predictive Role of Acute Physiology and Chronic Health Evaluation II (APACHE II) in Patients With Peritonitis at the National Hospital Abuja

Situ,

Badejo,

Gwaram

2024

Cureus

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“…However, most of these causes are due to unsanitary conditions and the use of contaminated water. The adaptation of a healthy lifestyle accompanied by early diagnosis and aggressive resuscitation, in addition to prompt surgical intervention can help avoid complications of acute peritonitis [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Causes of Acute Peritonitis and Its Complication

Kumar¹,

Garg²,

Sarwar³

et al. 2021

Cureus

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Introduction Peritonitis is a significant cause of morbidity and mortality in surgical settings. Coexisting premorbid illness and postoperative complications were found to be associated with death. This study aimed to analyze various etiologies that cause peritonitis and shed light on the factors responsible for unsatisfactory results. Method This longitudinal study included 309 patients above 12 years of age, of either gender, with confirmed diagnosis of peritonitis. Exploratory laparotomy was done to identify the cause of peritonitis. Patients were monitored postoperatively till their discharge or death for the development of complications. Results Our results showed that the most common cause of acute peritonitis was duodenal perforation (26.2%), followed by typhoid ileal perforation (24.2%) and ruptured appendix (16.8%). At least one complication was observed in 31% of the participants. The most common complication was dehydration (18.8%), followed by septicemia (11.3%) and paralytic ileus (6.4%). Ten (3.2%) patients died in the hospital. Conclusions Acute peritonitis is a serious surgical emergency caused by a number of diseases. Early surgical treatment along with antibiotics, followed by aggressive resuscitation can yield improved outcomes in patients with peritonitis.

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“…Ruptured appendix is third common cause in this study (17.59%) in another study by Batra P 2013 12 it was 3.82% and 24% in India by Sarkar S 2018 7 . Early surgical intervention with 6 hours along with broad spectrum antibiotics proceeded by aggressive resuscitation improved outcome of peritonitis 13 . Our low mortality was also due to same reasons.…”

Section: Discussionmentioning

confidence: 99%

Causes of Acute Peritonitis and its Outcome in Tertiary Medical Centre

Malik¹,

Iqbal²,

Magsi³

et al. 2019

J Liaq Uni Med Health Sci

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The study included 216 patients with acute peritonitis who underwent exploratory laparotomy from 2016 to 2018. Surgical treatment according to cause and post-operative treatment of disease carried out. Histopathological report and other diagnostic test like typhoid dot test and blood culture results were recorded and resultwas analyzed by SPSS version 24. RESULTS: Frequent causes of acute peritonitis were typhoid intestinal perforation 62(28.70%),Peptic ulcer perforation 54 (25%), rupture appendix 38 (17.59%), tuberculous intestine perforation 26 (12.05%), gangrene gut 14 (6.48%), large gut tumor perforation 10 (4.62%), ruptured liver abscess 4 (1.85%), ruptured gall balder 4 (1.85%) and acute pancreatitis 4 (1.85%). Complications were septic shock 30 (13.88%), paralytic ileus 16 (7.40%), burst abdomen 12 (5.5%) and mortality was 8 (3.70%.) CONCLUSION: Infectious diseases like typhoid, H-pylori PUD, ruptured appendix, ruptured liver abscess, and TB intestine are common causes of peritonitis.

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Effect of Early Surgery on Outcome In Perforation Peritonitis

Abstract: BACKGROUND

Cited by 3 publications

References 17 publications

Predictive Role of Acute Physiology and Chronic Health Evaluation II (APACHE II) in Patients With Peritonitis at the National Hospital Abuja

Predictive Role of Acute Physiology and Chronic Health Evaluation II (APACHE II) in Patients With Peritonitis at the National Hospital Abuja

Causes of Acute Peritonitis and Its Complication

Causes of Acute Peritonitis and its Outcome in Tertiary Medical Centre

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