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[Hospital mortality after emergency surgery for perforated diverticulitis].
Ned Tijdschr Geneeskd 2009; 153(25):1209-14NT

Abstract

OBJECTIVE

To assess which factors predict in-hospital mortality after emergency surgery for acute perforated diverticulitis.

DESIGN

Multicenter retrospective study.

METHOD

From 1995-2005 a total of 291 patients underwent surgery to treat perforated diverticulitis in five teaching hospitals in Rotterdam, the Netherlands. The relation to postoperative mortality of patient-related risk factors such as age, gender and classification according to the American Society of Anesthesiologists (ASA); disease severity factors such as Hinchey score and Mannheim peritonitis index (MPI); surgery-related risk factors, such as type of surgery, e.g. Hartmann’s procedure (HP) or resection with primary anastomosis; surgeon, and time of operation were evaluated using multivariate analysis.

RESULTS

The total postoperative in-hospital mortality was 29%. HP was performed 211 times and primary anastomosis was performed 75 times. HP was significantly more frequently performed in patients with higher values of age, ASA, Hinchey and MPI (all: p < 0.01). Multiple logistic regression analysis showed that age, ASA classification, Hinchey score, MPI and the absence of a specialist gastrointestinal surgeon during surgery, were important prognostic factors of mortality. Surgical technique was not related to postoperative mortality (adjusted odds ratio for mortality (HP versus primary anastomosis): 1.3; 95% CI: 0.6-2.9; p = 0.54).

CONCLUSION

The type of surgery did not appear to be a risk factor for high postoperative mortality. As well as patient-related risk factors, including age, ASA and severity of disease scores, such as Hinchey score and MPI, the absence of a specialist gastrointestinal surgeon during surgery was found to be a factor associated with high mortality risk.

Authors

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Pub Type(s)

English Abstract
Journal Article
Multicenter Study

Language

dut

PubMed ID

21696012

Citation

Vermeulen, Jefrey, et al. "[Hospital Mortality After Emergency Surgery for Perforated Diverticulitis]." Nederlands Tijdschrift Voor Geneeskunde, vol. 153, no. 25, 2009, pp. 1209-14.
Vermeulen J, Gosselink MP, Hop WC, et al. [Hospital mortality after emergency surgery for perforated diverticulitis]. Ned Tijdschr Geneeskd. 2009;153(25):1209-14.
Vermeulen, J., Gosselink, M. P., Hop, W. C., Lange, J. F., Coene, P. P., van der Harst, E., ... Mannaerts, G. H. (2009). [Hospital mortality after emergency surgery for perforated diverticulitis]. Nederlands Tijdschrift Voor Geneeskunde, 153(25), pp. 1209-14.
Vermeulen J, et al. [Hospital Mortality After Emergency Surgery for Perforated Diverticulitis]. Ned Tijdschr Geneeskd. 2009;153(25):1209-14. PubMed PMID: 21696012.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Hospital mortality after emergency surgery for perforated diverticulitis]. AU - Vermeulen,Jefrey, AU - Gosselink,Martijn P, AU - Hop,Wim C J, AU - Lange,Johan F, AU - Coene,Peter-Paul L O, AU - van der Harst,Erwin, AU - Weidema,Wilbo F, AU - Mannaerts,Guido H H, PY - 2011/6/24/entrez PY - 2011/6/24/pubmed PY - 2012/4/20/medline SP - 1209 EP - 14 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 153 IS - 25 N2 - OBJECTIVE: To assess which factors predict in-hospital mortality after emergency surgery for acute perforated diverticulitis. DESIGN: Multicenter retrospective study. METHOD: From 1995-2005 a total of 291 patients underwent surgery to treat perforated diverticulitis in five teaching hospitals in Rotterdam, the Netherlands. The relation to postoperative mortality of patient-related risk factors such as age, gender and classification according to the American Society of Anesthesiologists (ASA); disease severity factors such as Hinchey score and Mannheim peritonitis index (MPI); surgery-related risk factors, such as type of surgery, e.g. Hartmann’s procedure (HP) or resection with primary anastomosis; surgeon, and time of operation were evaluated using multivariate analysis. RESULTS: The total postoperative in-hospital mortality was 29%. HP was performed 211 times and primary anastomosis was performed 75 times. HP was significantly more frequently performed in patients with higher values of age, ASA, Hinchey and MPI (all: p < 0.01). Multiple logistic regression analysis showed that age, ASA classification, Hinchey score, MPI and the absence of a specialist gastrointestinal surgeon during surgery, were important prognostic factors of mortality. Surgical technique was not related to postoperative mortality (adjusted odds ratio for mortality (HP versus primary anastomosis): 1.3; 95% CI: 0.6-2.9; p = 0.54). CONCLUSION: The type of surgery did not appear to be a risk factor for high postoperative mortality. As well as patient-related risk factors, including age, ASA and severity of disease scores, such as Hinchey score and MPI, the absence of a specialist gastrointestinal surgeon during surgery was found to be a factor associated with high mortality risk. SN - 1876-8784 UR - https://www.unboundmedicine.com/medline/citation/21696012/[Hospital_mortality_after_emergency_surgery_for_perforated_diverticulitis]_ L2 - http://www.diseaseinfosearch.org/result/9681 DB - PRIME DP - Unbound Medicine ER -