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2018, Number 4

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Revista Cubana de Cirugía 2018; 57 (4)

Secondary peritonitis mortality in an intensive care unit

Sierra RE, Porro AC, Guindo GVL, Esteban SJA

Language: Spanish
References: 18
Page: 11-18
PDF size: 299.45 Kb.


ABSTRACT

Introduction: Secondary peritonitis is frequent, with high mortality indexes.
Objective: To establish the determining factors of the secondary peritonitis mortality in the intensive care unit of “Dr Agostinho Neto” hospital.
Method: A prospective longitudinal study was conducted in all the patients discharged from hospital with diagnosis of secondary peritonitis (n= 70). They were grouped into dead or alive patients. The following variables were studied: age, sex, personal pathological history and characteristics of peritonitis (clinical signs, causes, results of the peritoneal secretion culture, complications, antimicrobials used in treatment and severity scales). The statistical analysis was based on absolute frequencies, percentages and absolute risk.
Results: The patients were characterized by presenting with fever and leukocytosis with left deviation and by performance of peritoneal septic focus control (100 %). The multi-organ failure was common in dead patients. Acinetobacter species microorganism was isolated in the peritoneal fluid in addition to presenting immunosuppression; the associated mortality rates for these variables were 94.7 %, 80 % and 71.4 %, respectively.
Conclusions: The most associated factors to mortality were multi-organ failure, hypoxemia lower than or equal to 90 %, time of progression, clinical signs present for 24 hours or longer before the surgery, septic shock, age of 60 years or older, post-surgery intra-abdominal pressure equal to or over 21 cm H2O, colonic origin of peritonitis and presence of fecaloid peritoneal fluid.


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