Predicting the outcome of perforation peritonitis by using apache II scoring system

Gupta, Ankit; Sachan, Praveendra Kumar; Agrawal, Sanjay

doi:10.18203/2349-2902.isj20180020

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…Our present study is in accordance with the study done by Gupta et al in which most common site of perforation was first part of duodenum, which was similar to the study done by Jhobta et al 9,10 Second most common site according to Gupta et al was ileal (20%) which was again similar to the study done by Jhobta et al in which the incidence of ileal perforation was 22%. 9,10 According to Kumar et al, most common cause of perforation peritonitis was peptic ulcer perforation (36%) followed by typhoid ileal perforation (20%) followed by appendicular perforation (16%). 8 In present study highest incidence of SSI was seen in gastro duodenal perforations, 37.1% in control group and 20% in case group.…”

Section: Discussionsupporting

confidence: 92%

“…This is in accordance with the study done by Gupta et al which shows the peak incidence of 29% of SSI in age group of 17-30 years. 10 This is also in accordance with the study done by LekshmiPriya et al which shows the highest incidence of SSI (24.5%) in age group of 51-60 years. 1 Study done by Basith et al also supports our study and shows that age has a detrimental effect on the outcome of surgery with respect to SSI.…”

Section: Discussionsupporting

confidence: 92%

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A prospective study on pattern of superficial surgical site infections in patients undergoing emergency laparotomy for perforation peritonitis

2020

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Background: surgical site infections (SSIs) are recognized as a common surgical complication occurring in about 3% of all surgical procedures and in upto 20% of patients undergoing emergency intraabdominal procedures. Aims: To determine the incidence of SSIs in emergency laparotomies done for perforation peritonitis and the organisms involved and their sensitivity pattern in superficial SSI. The objective of the study was to determine the effect of planned intra operative intervention [antibiotic lavage with III generation cephalosporin e.g. ceftriaxone 1 gm and metronidazole 100 ml (5 mg per ml)] on superficial surgical site infection in emergency laparotomies done for perforation peritonitis.Methods: This prospective randomized case controlled study was carried out in P. G. Department of Surgery, S. R. N. Hospital associated with M. L. N. Medical College, Allahabad, from September 2018 to August 2019 after approval from the ethical committee and after obtaining written and informed consent either from patient or their guardian. Patients were divided into two groups viz. control group receiving the normal saline lavage and case group receiving the antibiotic lavage (III generation cephalosporins i.e., ceftriaxone (1 gm in 1000 ml NS) and metronidazole- 5 mg/ml (100 ml in 500 ml NS).Results: There is almost 50% incidence of SSI in emergency laparotomy done for perforation peritonitis. The most common organism involved in superficial SSI in present study was gut flora (E. coli) followed by normal skin colonizer (Staph. aureus).Conclusions: Intraperitoneal antibiotic lavage has a significant role in reducing the rate of SSI especially in gastroduodenal perforations.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

A prospective study on pattern of superficial surgical site infections in patients undergoing emergency laparotomy for perforation peritonitis

2020

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“…Gupta at el, in their study on 100 patients of perforation peritonitis concluded that for the prediction of death and complications in peritonitis, the physiological reserves of the patient is of great importance. 8 In their study they reported more than 65% mortality in patient with Apache II score of more than 20 and 100% mortality rate in score more than 34. They also observed that more the Apache II scoreless is the Hospital Stay as observed with our results.…”

Section: Discussionmentioning

confidence: 92%

“…6 The risk assessment by important clinical parameter has been extremely useful in evaluating new therapies, in monitoring resources utilization and improving the quality of care. 7,8 Many scoring systems have been found useful in predicting the outcome in critically ill patients, thus allowing application of resources for effective use. 9 Amongst them acute physiology and chronic health evaluation score (APACHE II), simplified acute physiology score (SAPS), sepsis severity score is mostly used and other scores specifically for peritonitis like the Mannheim peritonitis index and the peritonitis index altona II.…”

Section: Introductionmentioning

confidence: 99%

Apache II score in predicting surgical outcome in patients of secondary peritonitis: a prospective and observational study

et al. 2020

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Background: Peritonitis is defined as inflammation of the serosal membrane that lines the abdominal cavity and the organs contained therein. Secondary peritonitis presenting as acute generalized peritonitis is a common surgical emergency often associated with significant morbidity and mortality. Many scoring systems have been found useful in predicting the outcome in critically ill patients, thus allowing application of resources for effective use. Amongst them acute physiology and chronic health evaluation score (APACHE II), have a strong relationship to the outcome than previous groupings without consideration for systemic effect of the intra-abdominal sepsis. Methods: This study was conducted in the Department of General surgery, Sri Maharaja Hari Singh (SMHS) Hospital an associated hospital with the Government Medical College Srinagar, J&K, India. The prospective study was conducted over a period from October 2016 to September 2018 (Two Year) on 108 patients diagnosed with secondary peritonitis. Data was collected and analysed using SPSS v 20. Results: study included 108 patients with males involving 74.1% (80). The mean age of our study was 34 yr. (2-88 yr.), and 21-40 yr. (44.5%) group was mostly involved. Pain abdomen was present in 100% patients followed by nausea/vomiting (88%). Higher the APACHE VII score higher were post-operative complications (31+ score group 100%), mortality (31+ score group 100%) and less hospital stay (31+ score group 1.5 days) due to increased mortality. Conclusions: APACHE II score correlated well with postoperative complications, outcome, hospital stay. However, in patients with very high Apache score more than 30, the mean duration of hospital stay is less due to associated increased mortality during early Hospital stay.

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“…8 The study by Agrawal et al of 260 cases reported overall mortality of 10%. 11 Ramachandra et al had a mortality rate of 14%. 10 In our study 6 cases (12%) developed wound infections and 2 (4%) patients developed respiratory complications as postoperative complication.…”

Section: Complicationmentioning

confidence: 99%

Clinical evaluation, management and outcome of hollow viscus perforations

Anjaneya

Crithic

2019

Int Surg J

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Background: Gastrointestinal perforation is the third most common cause for exploratory laparotomy as an emergency. With the advent of drugs against acid peptic disease the incidence of peptic ulcer perforations is on decline. The advent of laparoscopy and endoscopy has played decisive role in the diagnosis and management of gastric and colorectal perforations. Aim of the study is to study the clinical outcome, surgical management and postoperative complication of peritonitis secondary to hollow viscus perforation.Methods: This was prospective study of 50 cases. All patients admitted and treated with perforation secondary to Hollow viscus perforations in surgical wards of M S Ramaiah Medical College, Bangalore, during the period of April 2016 to October 2017. Patients with peritonitis secondary to hollow viscus perforation admitted was evaluated and the diagnosis was made.Results: Out of 50 patients, most were male patients between 30-50 years age group. Duodenal ulcer perforation led the list. 4 were gastric, 37 were duodenal, 3 were jejunal, 6 cases were ileal. However colonic perforations were not observed. Wound infection leads the list of postoperative complications with faecal leak and burst abdomen following residual abscess. Almost all perforations were treated surgically.Conclusions: It was thought that with the introduction of better H2 receptor blockers and proton pump inhibitors, incidence of peptic perforations would decrease. Early recognition of perforations, prompt surgical intervention, adequate drainage, recognition of co-morbid conditions and complications would help in reduction of morbidity and mortality.

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Predicting the outcome of perforation peritonitis by using apache II scoring system

Cited by 4 publications

References 6 publications

A prospective study on pattern of superficial surgical site infections in patients undergoing emergency laparotomy for perforation peritonitis

A prospective study on pattern of superficial surgical site infections in patients undergoing emergency laparotomy for perforation peritonitis

Apache II score in predicting surgical outcome in patients of secondary peritonitis: a prospective and observational study

Clinical evaluation, management and outcome of hollow viscus perforations

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