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Relaparotomies: Why is Mortality Higher?
Ercan Gedik1,2, Kazým Söylemez3, Sadullah Girgin3
1Department of General Surgery, Dicle University, Diyarbakir, Turkey. egedik@dicle.edu.tr.
Summary
Relaparotomy, or repeat abdominal surgery, has high mortality. Advanced age and a high APACHE II score (≥ 20) are independent risk factors for death after these procedures.
Area of Science:
- Abdominal Surgery
- Surgical Outcomes
- Critical Care Medicine
Background:
- Relaparotomy is frequently necessary for managing post-abdominal surgery complications.
- These repeat surgeries are associated with a significantly high mortality rate.
- Identifying independent risk factors for mortality is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the independent risk factors associated with mortality in patients undergoing relaparotomy.
- To analyze various patient characteristics and clinical data to determine predictors of death.
Main Methods:
- A retrospective evaluation of 114 patients who underwent relaparotomy.
- Data collected included patient demographics, surgical history, systemic diseases, peritonitis, APACHE II scores, and blood transfusion units.
- Multivariate logistic regression analysis was employed to identify independent risk factors.
Main Results:
- The most frequent indication for relaparotomy was leakage from intestinal repair or anastomosis (29.8%).
- Mortality occurred in 48.2% of patients.
- Independent risk factors for mortality identified were advanced age (OR 0.966, p=0.017) and an APACHE II score of 20 or higher (OR 0.137, p<0.0001).
Conclusions:
- Advanced age is an independent risk factor for mortality following relaparotomy.
- An APACHE II score of 20 or greater is a significant independent predictor of mortality in patients undergoing repeat abdominal surgery.
