Factors of unfavorable outcome of generalized peritonitis
Abstract
Aim . To analyze clinical and bacteriologic factors associated with the occurrence of septic shock and mortality in patients with secondarily generalized peritonitis. Materials and methods . The analysis of the results of the examination and treatment of 180 patients with generalized peritonitis was carried out. Patients were divided into two groups: the first group of 74 patients (41.1%) who had septic shock and the second group of 106 patients (58.9%) without a record of septic shock. Further, subgroups of patients with community-acquired and postoperative generalized peritonitis were identified in a ratio of 112/68. Results and discussion . Mortality among patients with community-acquired peritonitis was 21% and among patients with postoperative peritonitis - 16%. 42 (37%) patients with community-acquired peritonitis developed septic shock compared with 32 (47%) cases of shock among patients with postoperative peritonitis. Patients who developed septic shock were significantly older than patients without septic shock in both subgroups. In both types of generalized peritonitis, anaerobes are significantly associated with septic shock. Conclusions . It was revealed that age over 65 years, two or more microorganisms of the peritoneal fluid, or anaerobes were independent risk factors for the development of septic shock. Peritoneal exudate yeast and enterococci were associated with septic shock in a subgroup of patients with community-acquired peritonitis. Yeast was associated with high mortality in postoperative peritonitis.