A cohort study of patterns, treatment outcomes and predictors of mortality in patients with secondary generalized peritonitis in two referral hospitals in Addis Ababa, Ethiopia

一项针对埃塞俄比亚亚的斯亚贝巴两家转诊医院继发性弥漫性腹膜炎患者的模式、治疗结果和死亡率预测因素的队列研究

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Abstract

BACKGROUND: There is paucity of data on the outcomes and factors affecting the outcomes of patients with secondary peritonitis in developing countries especially Ethiopia. We studied these groups of patients to determine the etiologies, outcome and predictors of mortality. METHODS: This study was retrospective cohort study of 235 patients. Patients who underwent surgery for secondary generalized peritonitis in two centers in Ethiopia were included to determine the patterns, outcomes and predictors of mortality during their admission. The patients' various clinical, epidemiological, laboratory and intraoperative variables were analyzed to detect those that have significant relation with outcome. P value of < 0.05 with confidence interval of > 95% was used to determine statistical significance. RESULTS: A total of 235 patients were enrolled in the study. Perforated peptic ulcer disease and perforated appendicitis were the most common cases operated. Mortality was determined to be 6.8% with the most common cause being multi-organ failure secondary to septic shock of gastrointestinal focus. A total of 21.7% of the patients have a complicated post-operative course. Through logistic regression analysis duration of surgery and intraoperative vasopressor requirement were significantly associated with mortality of patients. CONCLUSION: The mortality reported in this study is comparable to other African studies. The etiologies were slightly different with perforated peptic ulcer disease and perforated appendicitis accounting for most cases. The occurrence of complications and mortalities were associated with various epidemiological, clinical, laboratory and intraoperative factors.

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