Delay in Management of Acute Peritonitis and Its Effect on 30-Day Mortality
DOI:
https://doi.org/10.36283/PJMD13-2/006Keywords:
Peritonitis, General Surgery, Mortality, Morbidity, LaparotomyAbstract
Background: Peritonitis is a grievous surgical emergency, characterized by the inflammation of the peritoneum and a major cause of morbidity and mortality in surgical situations. This study investigated the delayed presentation impact on 30-day mortality in emergency laparotomies for peritonitis patients in Karachi.
Methods: This longitudinal study was employed on 148 peritonitis patients at Jinnah Postgraduate Medical Centre, selected through non-probability convenient sampling. The study included secondary peritonitis-diagnosed patients of all ages and genders admitted from December 2022 to August 2023. Data encompassed pre-hospital experiences, care received at our center, and previous medical consultations. National Exploratory Laparotomy Audit (NELA) score estimated the 30-day mortality rate. SPSS version 26.0 was used, with qualitative variables presented as percentages and frequencies, considering p<0.05 significant.
Results: The majority of our patients were male 106(71.6%) with ages 19-30(41.2%). Among admitted patients, 59(40.3%) had primary education while 41(28%) had none, indicating educational disparities. Financial constraints were evident, with 45(30.2%) earning less than 15,000PKR monthly. The mean delay in presenting to the first practitioner was 2.98 days. Local general practitioners were consulted by 59.1% before reaching our facility. Total delay time correlated significantly with the NELA score (p<0.001). Extended travel distances (72.4% traveled far) correlated with delayed presentation (p=0.019). Differences in systolic blood pressure and respiratory rate were noted between mortality and non-mortality groups (p-value<0.05).
Conclusion: The study underscores the substantial contribution of delayed presentation to mortality in peritonitis patients undergoing emergency laparotomy. Addressing such issues could potentially enhance patient outcomes and reduce mortality in emergency surgeries.
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