A Retrspective Study to Evaluate the Indicators of Mortality in Cases of Perforative Peritonitis in Tertiary Care Hospital

INTRODUCTION: perforative peritonitis is still a major challenge for surgeons and is complicated and the mortality rate is still high. Causes of Perforative peritonitis in our country is different than that in western world. It is therefore important to recognize the main indicators of mortality in cases of perforative peritonitis and the objective of my study is to retrospectively study the indicators . MATERIALS AND METHODS: All patients diagnosed as peritonitis and admitted to Surgical Ward or who develop features of peritonitis due to various causes after being admitted between the period JULY 2012 to JUNE 2014. Patients with gynecological peritonitis, biliary peritonitis, post operative peritonitis were excluded from the study. RESULTS: Patients with peritonitis admitted in surgery ward were studied .Total number cases studied were 100. The patients with age ranging from 17 years – 75 years were studied.Mortality rate was more in extremes of age that is ≤ 20 years > 50 years group. The mortality rate of elderly patient was 100% (1 patient). Maximum number of patients were male – 90, but mortality rate was more in females. Since maximum patients were males, the number of patient died were maximum in males. Mortality increased correspondingly with delay in perforation. It was 10% for <24hours, 74% >6 days . Perforations were grouped into 8 aetiologies. As many as 54 patients (54%) presented with shock on day 1. They had high mortality of 27 (50%) in comparison to 4 (10%) in patients without shock. CONCLUSION: In this Retrospective study various factors affecting both mortality and morbidity in peritonitis patientswere studied. Extremes of age (≤ 20 yrs, > 50 yrs) seem to have adverse effect on the outcome. The impact of sex outcome could not be conclusively proved, even though female patient seem to have poorer prognosis. Type and extent of peritoneal contamination seem to have bearing on mortality.Patients with diffuse peritonitis, faecal contamination do worse. Associated factors like diabetes, cardiovascular problems add to mortality. There is wide scope for use of Mannheim peritonitis index, sepsis score of Elebute and Stoner in present context.