Risk factors and predictors of mortality in cases of on-demand relaparotomy due to complicated intraperitoneal Sepsis: a prospective study

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Abstract

Background: Relaparotomy patients burden healthcare systems, especially in low-income centers. With over occupying
ICU beds at the hospital, numerous patients were not admitted to the ICU despite multiple surgeries and adverse events
requiring strict supervision, so in this study we aimed to determine the risk factors and predictors of mortality in patients
who underwent on-demand re-laparotomy (OD) due to complicated intraperitoneal sepsis.
Methods: A total of 113 patients who needed re-laparotomy for complicated intraperitoneal sepsis were included in the
study. Patients who underwent planned re-laparotomy (PR) or were re-explored laparoscopically were excluded. We
followed with laboratory and radiological investigations to evaluate improvement, wound infection, anastomotic leakage,
hemorrhage, burst abdomen, surgical re-exploration and mortality.
Results: Mortality was greater in males (87.9 %), patients with chronic kidney disease (12.1 %), patients with coronavirus
disease 2019 (27.3 %), patients with a negative surgical history of previous abdominal surgery, and patients with a
presentation of acute abdomen (60.6 %). There were statistically significant differences between survived and mortality
cases in terms of the procedure, operative findings, surgical site, preoperative shock, surgical procedure, admission to the
ICU, and outcome of the intervention.
Multi-organ failure Conclusion: Our study revealed the following factors are predictors of mortality in patients who
needed OD due to complicated intraperitoneal sepsis: , pre-re-exploration shock, a time since primary surgery 7 days or
more, the operative finding of mesenteric vascular occlusion and intestinal gangrene, intestinal leakage, postoperative
ICU admission, postoperative burst abdomen, and postoperative chest infection.

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