Resumen

HONORIO-HORNA, Carlos Enrique et al. Factores de riesgo de Morbilidad y Mortalidad en pacientes con Perforación Tífica Ileal. Rev. gastroenterol. Perú [online]. 2006, vol.26, n.1, pp.25-33. ISSN 1022-5129.

OBJECTIVES: To determine the risk factors, morbidity and mortality rates and the types of postoperative complications in patients undergoing surgery for ileal typhoid perforation. MATERIAL AND METHODS: This retrospective study evaluated 126 patients with anatomohistological diagnosis of ileal typhoid perforation treated at the Belen Hospital, Trujillo, Peru between 1966 and 2000.  RESULTS: The average age of the total series was of 21.39 + 13.4 years (range 1 to 57 years); of which, 97 (76.98%) were male and 29 (23.02%) women (proportion M:F, 3.3:1). By means of univariate analysis, the morbidity was related with the absence of previous medical treatment (p=0.035). The mortality was associated to time of perforation exceeding 48 hours (p=00001); digestive hemorrhages (p=0.003), leukocyte count (p=0.021) fecaloid peritoneal secretion (p=0.007) number of perforations (p=0.001) and the surgical technique, that presented major mortality was the resection and ileostomy (48.3%; p=0.001). The group of patients that presented post-surgical complications was 80.16%, of which 19.8% of them died. The most frequent complications were wound infections (67.3%) and sepsis (27.7%). In the multivariate analysis two parameters were evidenced in relation to morbidity: previous medical treatment (p <0.05; OR=2.9) and number of perforations (p=0.01; OR=6.4). With regard to mortality the significant statistical parameters were: low digestive hemorrhages (p=0.02; OR=11.4) leukocyte count (p <0.008; OR = 7.9) type of operation (p=0.03; OR=1.8) peritoneal secretion (p <0.04; OR = 3.02) and number of perforations (p=0.008; OR = 4.6).  CONCLUSIONS: The risk factors identified in the present series can be useful to elaborate a risk scale to predict a small, moderate or greater probability of complications and postoperative mortality.

Palabras clave : Typhoid perforation; risk factors; morbidity; mortality.

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