Mortality due to secondary peritonitis in the General Teaching Hospital ¨Dr. Agostinho Neto¨ from Guantánamo. Determining factors
Journal: Revista Información Científica (Vol.97, No. 1)Publication Date: 2018-01-16
Authors : Yondris Reyes Domínguez José Alfredo Esteban Soto Ernesto Ramírez Núñez;
Page : 67-75
Keywords : peritonitis; unit of intensive cares; acute surgical abdomen;
Abstract
Introduction: the factors that determine the prognosis of the patient with peritonitis are not always known in the intensive care unit. Objective: to determine the determinants of mortality due to secondary peritonitis in this unit at the Hospital "Dr. Agostinho Neto” during the years 2014-2016. Method: a prospective, longitudinal, and analytical study was conducted of all the patients admitted to the ICU for secondary peritonitis in the years 2014-2016 (n=70), which were grouped according to graduates alive or deceased. The variables most related to the probability of the patient's death and the most frequent in the deceased were specified. The absolute risk (AR) of each variable was calculated. Results: the most frequent factors were: fever (n = 53), systemic inflammatory response syndrome (n = 51) and left leukocytosis/deviation (n = 51); the factors most likely to determine death were multiorgan failure (RA 17.8), fecaloid peritoneal fluid (RA 7.8) and septic shock (RA 7.3). Conclusions: The factors that determine mortality due to secondary peritonitis: diffuse peritonitis, presence of multi-organ failure, hypoxemia ≤ 85 mmHg or Sp02 ≤ 90 %, age ≥ 60 years, intra-abdominal pressure after surgery ≥ 21 cm H2O (15 mmHg), symptoms ≥ 24 h before surgery, septic shock, fecaloid peritoneal fluid, colonic origin of peritonitis.
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