Patient outcomes and prognostic factors associated with colonic perforation surgery: a retrospective study
Open Access
- 30 April 2022
- journal article
- research article
- Published by Yeungnam University College of Medicine in Journal of Yeungnam Medical Science
- Vol. 39 (2), 133-140
- https://doi.org/10.12701/yujm.2021.01445
Abstract
Background: Despite advances in surgery and intensive perioperative care, fecal peritonitis secondary to colonic perforation is associated with high rates of morbidity and mortality. This study was performed to review the outcomes of patients who underwent colonic perforation surgery and to evaluate the prognostic factors associated with mortality. Methods: A retrospective analysis was performed on 224 consecutive patients who underwent emergency colonic perforation surgery between January 2008 and May 2019. We divided the patients into survivor and non-survivor groups and compared their surgical Results: The most common cause of colon perforation was malignancy in 54 patients (24.1%), followed by iatrogenic perforation in 41 (18.3%), stercoral perforation in 39 (17.4%), and diverticulitis in 37 (16.5%). The sigmoid colon (n= 124, 55.4%) was the most common location of perforation, followed by the ascending colon, rectum, and cecum. Forty-five patients (20.1%) died within 1 month after surgery. Comparing the 179 survivors with the 45 non-survivors, the patient characteristics associated with mortality were advanced age, low systolic blood pressure, tachycardia, organ failure, high C-reactive protein, high creatinine, prolonged prothrombin time, and high lactate level. The presence of free or feculent fluid, diffuse peritonitis, and right-sided perforation were associated with mortality. In multivariate analysis, advanced age, organ failure, right-sided perforation, and diffuse peritonitis independently predicted mortality within 1 month after surgery. Conclusion: Age and organ failure were prognostic factors for mortality associated with colon perforation. Furthermore, right-sided perforation and diffuse peritonitis demonstrated a significant association with patient mortality.Keywords
This publication has 25 references indexed in Scilit:
- Chirurgische Therapie der PeritonitisDer Chirurg, 2011
- Surgery for perforated colorectal malignancy in an Asian population: an institution’s experience over 5 yearsInternational Journal of Colorectal Disease, 2010
- Avoiding or Reversing Hartmann’s Procedure Provides Improved Quality of Life After Perforated DiverticulitisJournal of Gastrointestinal Surgery, 2010
- Differences in patient postoperative and long-term outcomes between obstructive and perforated colonic cancerThe American Journal of Surgery, 2008
- The survival rate and prognostic factors in 26 perforated colorectal cancer patientsInternational Journal of Colorectal Disease, 2006
- Classification of Surgical ComplicationsAnnals of Surgery, 2004
- Factors Affecting the Early Mortality of Patients with Nontraumatic Colorectal PerforationSurgery Today, 2003
- Large bowel perforation: morbidity and mortalityTechniques in Coloproctology, 2002
- Prognostic factors for mortality in left colonic peritonitis: a new scoring systemJournal of the American College of Surgeons, 2000
- Prognostic factors for survival in colonic perforationInternational Journal of Colorectal Disease, 1994