Export Objective: Secondary peritonitis remains a significant surgical emergency worldwide, associated with high morbidity and mortality, especially in resource-limited settings. Early identification of prognostic factors is critical to improving patient outcomes. This study aimed to evaluate clinical outcomes and identify predictors of mortality in patients undergoing emergency laparotomy for secondary peritonitis at a general referral hospital in Sana’a, Yemen. Methods: This prospective observational study included 74 patients aged ≥15 years diagnosed with secondary peritonitis between January 2023 and January 2024. Data on demographics, clinical presentation, comorbidities, qSOFA scores, intraoperative findings, postoperative complications, and outcomes were collected. Statistical analyses included univariate and multivariate logistic regression to identify predictors of mortality. Results: The mean age was 42.0 ± 18.3 years; 62.2 % were males. The most common cause of peritonitis was perforated appendicitis (31.1%), followed by strangulated bowel (23.0%) and perforated peptic ulcer (21.6%). A qSOFA score ≥2 was observed in 39.2% of patients. Postoperative complications occurred in 48.6%, with wound infection (27.0%) being the most frequent. The overall mortality rate was 21.6%. Multivariate analysis identified postoperative complications odds ratio(OR) 4.5; 95% confidence interval (CI) 1.8–11.3; P = 0.001 and qSOFA score ≥2 (OR 3.2; 95% CI 1.1–9.0; P = 0.03) as independent predictors of mortality. Conclusions: Secondary peritonitis carries substantial mortality in this setting, strongly influenced by postoperative complications and the severity of organ dysfunction at presentation. Early recognition and management of high-risk patients using clinical scores such as qSOFA, along with vigilant postoperative care, are essential to improve outcomes.
Amry et al. (Tue,) studied this question.