PURPOSE: The aim of this study was to evaluate the risk factors and outcome of patients with hyperbilirubinemia after surgery for generalized peritonitis. METHODS: We retrospectively analyzed data from 229 patients with generalized peritonitis caused by gastrointestinal (GI) perforations. RESULTS: Postoperative hyperbilirubinemia defined as a value of > or =5 mg/dl, within 1 month, developed in 39 patients. Postoperative hyperbilirubinemia was related to age ( P = 0.0102), poor nutritional status ( P = 0.0388), decreased base excess ( P = 0.0037), delay until surgery ( P = 0.0276), preoperative serum bilirubin ( P = 0.0321) and postoperative persistent infection ( P < 0.0001). Higher mortality was seen in patients with hyperbilirubinemia (59%) than in those without hyperbilirubinemia (4%). The patients with hyperbilirubinemia who survived had decreased serum bilirubin levels after 3-5 postoperative days whereas a continuous increase was seen in the patients who ultimately died. Preoperative shock ( P = 0.0003), a decreased preoperative platelet count ( P = 0.0152), postoperative infection ( P = 0.0050), and postoperative hyperbilirubinemia ( P < 0.0001) were risk factors for overall mortality. CONCLUSION: These results indicate that postoperative hyperbilirubinemia in patients with GI perforation is related to persistent postoperative infection and associated with poor prognosis.
PURPOSE: The aim of this study was to evaluate the risk factors and outcome of patients with hyperbilirubinemia after surgery for generalized peritonitis. METHODS: We retrospectively analyzed data from 229 patients with generalized peritonitis caused by gastrointestinal (GI) perforations. RESULTS:Postoperative hyperbilirubinemia defined as a value of > or =5 mg/dl, within 1 month, developed in 39 patients. Postoperative hyperbilirubinemia was related to age ( P = 0.0102), poor nutritional status ( P = 0.0388), decreased base excess ( P = 0.0037), delay until surgery ( P = 0.0276), preoperative serum bilirubin ( P = 0.0321) and postoperative persistent infection ( P < 0.0001). Higher mortality was seen in patients with hyperbilirubinemia (59%) than in those without hyperbilirubinemia (4%). The patients with hyperbilirubinemia who survived had decreased serum bilirubin levels after 3-5 postoperative days whereas a continuous increase was seen in the patients who ultimately died. Preoperative shock ( P = 0.0003), a decreased preoperative platelet count ( P = 0.0152), postoperative infection ( P = 0.0050), and postoperative hyperbilirubinemia ( P < 0.0001) were risk factors for overall mortality. CONCLUSION: These results indicate that postoperative hyperbilirubinemia in patients with GI perforation is related to persistent postoperative infection and associated with poor prognosis.
Authors: Sujit M Chakma; Rahul L Singh; Mahadev V Parmekar; K H Gojen Singh; Buru Kapa; K H Sharatchandra; Amenla T Longkumer; Santhosh Rudrappa Journal: J Clin Diagn Res Date: 2013-11-10
Authors: Ascanio Tridente; Geraldine M Clarke; Andrew Walden; Anthony C Gordon; Paula Hutton; Jean-Daniel Chiche; Paul A H Holloway; Gary H Mills; Julian Bion; Frank Stüber; Christopher Garrard; Charles Hinds Journal: Crit Care Date: 2015-05-05 Impact factor: 9.097
Authors: Young Ran Hong; Chul-Woon Chung; Jong Woo Kim; Chang Il Kwon; Dae Ho Ahn; Sung Won Kwon; Seong Ki Kim Journal: J Korean Soc Coloproctol Date: 2012-10-31