Factors predicting in-hospital mortality of patients with diffuse peritonitis from perforated colonic diverticulitis

Ann Ital Chir. 2012 Jul-Aug;83(4):319-24.

Abstract

Aim: Diverticulitis free perforation still remains a major life-threatening condition. Herein we evaluate factors influencing prognosis of patients with perforated colonic diverticulitis and the current validity of Mannheim Peritonitis Index (MPI) in predicting mortality.

Material of study: From January 2000 to October 2010, 39 patients were operated on for generalized peritonitis from perforated diverticulitis

Results: Five postoperative deaths (12.8%) related to septic shock occurred. A cross-sectional study between deceased and non-deceased patients was carried out. Deceased patients were significantly older than non-deceased (76.4 vs. 59.1 years,p=0.019); duration of symptoms was longer in deceased patients (102 vs. 26.9 hours, p=0.000); MPI was higher in deceased patients (31.4 vs. 21.2, p=0.000). Age, duration of symptoms and MPI were independent risk factors predicting poor prognosis. The highest sensitivity and specificity of MPI in predicting mortality was shown for a score higher than 27.

Conclusions: MPI is still effective in predicting postoperative mortality. People who nurse older persons must pay higher attention to complaints in order to reduce the delay in hospitalization.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Diverticulitis, Colonic / complications*
  • Diverticulitis, Colonic / mortality*
  • Female
  • Hospital Mortality*
  • Humans
  • Intestinal Perforation / etiology*
  • Intestinal Perforation / mortality*
  • Male
  • Middle Aged
  • Peritonitis / etiology*
  • Peritonitis / mortality*
  • Prognosis