Analysis of Risk Factors in Nontraumatic Perforation Peritonitis- Review from A Rural Medical College

The objective was to retrospectively analyze data of non-traumatic gastrointestinal perforations in a 10 year period from a rural medical college and statistically evaluate the risk factors for mortality. A retrospective study of four hundred and sixty four patients admitted in a span of ten years (between January 1997 to December’2006) was done and data regarding clinical presentation, operative findings, postoperative course were studied and analyzed. The cases of traumatic perforation were excluded. The data was analysed using chi square and binary logistic regression tools. The mortality was 13.79%. The risk factors identified by statistical tools were, factors such as age above 50 years, delay of more than 24 hours for hospitalization, shock on admission (if systolic blood pressure was less than 90 mmHg), associated comorbid conditions, colonic or rectal perforation, prolonged operating time (more than 90 minutes for simple closure and more than 120 minutes for resection) andpost operative complication. The mortality in cases of gastrointestinal perforation depends upon number of the risk factors and their severity. Age of 50 years, shock on admission, pre-existing illness and post operative complications appear to be the more significant factors. Key words: intestinal perforation, peritonitis, risk factors.