• Eur J Trauma Emerg S · Dec 2009

    Relaparotomies: Why is Mortality Higher?

    • Ercan Gedik, Kazým Söylemez, Sadullah Girgin, Ersin Uysal, and Ýbrahim Taçyýldýz.
    • Department of General Surgery, Dicle University, Diyarbakir, Turkey. egedik@dicle.edu.tr.
    • Eur J Trauma Emerg S. 2009 Dec 1;35(6):547-52.

    BackgroundRelaparotomy is sometimes required for complications that develop after abdominal surgery, but it is associated with high mortality. We aimed to investigate the independent risk factors related to mortality in patients that undergo relaparotomies.Materials And MethodsOne hundred and fourteen patients who had relaparatomies were evaluated. Risk factors studied were patient characteristics, cause of the first operation, condition of the first operation, systemic diseases, presence of peritonitis, relaparotomy interval, cause of relaparatomy, APACHE II score, transfused blood units, number of relaparatomies, length of hospital stay, and mortality. In order to determine the independent risk factors, we carried out multivariate logistic regression analysis.ResultsThere were 75 male and 39 female patients with a mean age of 46.06 ± 19.98 (15-84). The most common reasons for relaparotomy were leakage from intestinal primary repair or anastomosis (29.8%). Mortality developed in 55 (48.2%) patients undergoing relaparatomy. Intestinal necrosis (p = 0038) and intraabdominal sepsis (p = 0.027) were found to be risk factors in mortality. In multivariate logistic regression analysis, advanced age (OR 0.966, p = 0. 0.017) and APACHE II score ≥ 20 (OR 0.137, p < 0.0001) were found to be independent risk factors affecting mortality.ConclusionAdvanced age and APACHE II score ≥ 20 were found to be independent risk factors affecting relaparotomy-related mortality.

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