Prognostic Factors in Critically Ill Patients Suffering from Secondary Peritonitis: A Retrospective, Observational, Survival Time Analysis

Abstract

Four-month prognosis of critically ill, surgical patients with secondary peritonitis is poor and mostly determined by the ability to obtain source control. Outcome has improved since 2002, and after successful surgical and intensive care therapy long-term survival seems to be good.

Long-Term Vacuum-Assisted Closure in Open Abdomen due to Secondary Peritonitis: A Retrospective Evaluation of a Selected Group of Patients

“…Furthermore, this study clearly affirms that long-term treatment of open abdomen due to secondary peritonitis is still associated with a high mortality rate and therefore demonstrates the need of a separate appraisal of this group of patients [2]. Even though our results affirm studies showing that the MPI is of limited prognostic value [25], severity of secondary peritonitis at first re-exploration was, beside split-thickness skin grafting, the only expedient prognostic parameter (table 2).…”

“…Though, as described by Kirschner and Nordmann [1] in 1941, the discussion about an optimal concept of drainage has not ended, yet. Peritonitis is still associated with a high mortality rate of about 50%, which emphasizes the need for further improvement of treatment [2]. …”

What Is the Role of Source Control in Sepsis?

“…The ability to obtain source control is an important prognostic factor in critically ill patients suffering from secondary peritonitis. 16 An adverse prognosis is associated with disease severity at intensive care unit (ICU) admission and over the ICU stay, specific comorbidities (extended malignancies, liver cirrhosis), certain sites of infection (distal esophagus, stomach), and an inadequate initial antibiotic therapy. 16 …”

Management of Intra-Abdominal Infections

“…Timing and adequacy of source control are currently the most important issues in the management of IAIs because inadequate and late operation may have a negative effect on outcome [64][65][66][67][68][69]. The optimal timing of source control has not been rigorously investigated.…”