Preoperative Predictors of Mortality in Patients with Perforation Peritonitis

Background: Perforation peritonitis is the most common surgical emergency in India. Despite advances in surgical techniques, antimicrobial therapy and intensive care support, management of peritonitis continues to be highly demanding, difficult and complex. The spectrum of etiology of perforation continues to be different from that of western countries and there is paucity of data from India regarding it’s etiology, prognostic indicators, morbidity and mortality patterns. Aims and Objective: Our research sought to show the variety of perforation peritonitis that we encountered at the LLRM Medical College and Hospital Meerut as Despite the fact that perforation peritonitis has implications that contemporary surgeons cannot avoid but by applying preoperative predictors effectively, they can diagnose a patient’s condition and reduce the mortality burden on society. Materials and Methods: Seventy consecutive patients admitted to LLRM MEDICAL COLLEGE MEERUT with perforation peritonitis, of age more than 12 years scheduled for emergency laparotomy were studied prospectively. The parameters studied were age and sex of the patients, history of chronic smoking ,duration of symptoms, SBP, pulse rate, respiratory rate, oxygen saturation on presentation ,delay in initiating surgical intervention, and preoperative biochemical parameters such as hemoglobin and serum creatinine. In-hospital mortality was taken as the outcome. Results: We encountered a mortality of 24.28% in our study. Multiple linear (enter) regression identified the age, duration of symptoms, SBP on presentation, SPO2 on presentation respiratory rate on presentation, serum creatinine levels, and the delay in instituting surgical intervention as independent predictors of mortality. Conclusion: Routine biochemical investigations, delay in presentation and surgical intervention are good predictors of mortality. Recognizing such patients early with risk stratification and providing early goal-directed therapy can improve the outcome.