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Mortality risk factor analysis in colonic perforation: would retroperitoneal contamination increase mortality in colonic perforation?

Abstract：

Purpose:Colonic perforation is a lethal condition presenting high morbidity and mortality in spite of urgent surgical treatment. This study investigated the surgical outcome of patients with colonic perforation associated with retroperitoneal contamination. Methods:Retrospective analysis was performed for 30 patients diagnosed with colonic perforation caused by either inflammation or ischemia who underwent urgent surgical treatment in our facility from January 2005 to December 2014. Patient characteristics were analyzed to find risk factors correlated with increased postoperative mortality. Using the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) audit system, the mortality and morbidity rates were estimated to verify the surgical outcomes. Patients with retroperitoneal contamination, defined by the presence of retroperitoneal air in the preoperative abdominopelvic CT, were compared to those without retroperitoneal contamination. Results:Eight out of 30 patients (26.7%) with colonic perforation had died after urgent surgical treatment. Factors associated with mortality included age, American Society of Anesthesiologists (ASA) physical status classification, and the ischemic cause of colonic perforation. Three out of 6 patients (50%) who presented retroperitoneal contamination were deceased. Although the patients with retroperitoneal contamination did not show significant increase in the mortality rate, they showed significantly higher ASA physical status classification than those without retroperitoneal contamination. The mortality rate predicted from Portsmouth POSSUM was higher in the patients with retroperitoneal contamination. Conclusion:Patients presenting colonic perforation along with retroperitoneal contamination demonstrated severe comorbidity. However, retroperitoneal contamination was not found to be correlated with the mortality rate.

journal_name

Ann Surg Treat Res

journal_title

Annals of surgical treatment and research

authors

Yoo RN,Kye BH,Kim G,Kim HJ,Cho HM

doi

10.4174/astr.2017.93.4.203

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

203-208

issue

eissn

2288-6575

issn

2288-6796

journal_volume

pub_type

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Mortality risk factor analysis in colonic perforation: would retroperitoneal contamination increase mortality in colonic perforation?