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Prognostic factors in typhoid perforation

Muzaffar Aziz1, Abdul Qadir, Muzammil Aziz

  • 1Department of Surgery, Nishtar Hospital, Multan. drmuzaffaraziz@yahoo.com

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|November 23, 2005
PubMed
Abstract

Insights

Early typhoid perforation and prompt surgery significantly improve patient outcomes. Delayed presentation and surgical intervention correlate with higher mortality and morbidity rates in typhoid perforation cases.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Prognosis

Background:

  • Typhoid perforation is a serious complication of Salmonella Typhi infection.
  • Prognosis is influenced by factors such as illness duration and surgical timing.
  • Understanding these factors is crucial for improving patient management.

Purpose of the Study:

  • To evaluate the impact of illness duration before perforation on typhoid perforation prognosis.
  • To assess the effect of the time interval between perforation and surgery on patient outcomes.
  • To identify key prognostic indicators for typhoid perforation.

Main Methods:

  • A comparative study involving 72 patients with typhoid perforation.
  • Patients were grouped based on the duration of illness before perforation (1st, 2nd, 3rd week).
  • Patients were also grouped by the time to surgical intervention (within 24h, 24-48h, after 48h).

Main Results:

  • Mortality rates increased with delayed perforation (6.6% to 25%) and delayed surgery (8.33% to 22.2%).
  • Morbidity rates also showed a similar trend, rising with delayed diagnosis and treatment.
  • Early perforation and timely surgery were associated with better outcomes.

Conclusions:

  • Early presentation of typhoid perforation is a positive prognostic sign.
  • A shorter interval between perforation and surgical intervention improves patient prognosis.
  • Optimizing patient presentation and surgical timing are essential for better results in typhoid perforation.

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