Morbidity and mortality in relaparotomized patients in critical care units
Keywords:
relaparotomized patients, relaparotomy; on-demand relaparotomy; relaparotomy predictive indexAbstract
Introduction: Relaparotomy is a planned or unplanned reintervention that is carried out during the postoperative period of laparotomy, mainly due to complications of primary abdominal surgery, associated with greater morbidity and mortality.
Objective: To characterize the morbidity and mortality in relaparotomized patients in critical care units.
Methods: An observational, descriptive, retrospective, cross-sectional study was carried out in the intensive and intermediate care units of the Provincial Clinical Surgical University Hospital Comandante Faustino Pérez Hernandez, in Matanzas, from January 1, 2020 to December 31, 2022. The sample consisted of 23 patients who required relaparotomy. Sociodemographic and clinical variables were reported.
Results: Deceased patients predominated, represented by the group aged 60 years and older. On-demand relaparotomy, patients with three or more relaparotomies, relaparotomies between 72 hours and up to seven days, intra-abdominal sepsis as the cause of admission to the unit and relaparotomy prevailed, and were related to the highest number of deaths. All patients who developed septic shock died. The group with Mannheim peritonitis index of 30 and more, and the relaparotomy predictive index between 11 and 14 related to higher mortality, stood out.
Conclusions: The early application of the Mannheim peritonitis index and the relaparotomy predictive index are useful to decide on a relaparotomy and reduce the associated morbidity and mortality. The scheduling of a relaparotomy from an initial surgery constitutes a cornerstone for a satisfactory evolution.
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Nivelo Zumba JE, Vera Macías JJ, Cabezas Dillon CA, et al. Relaparotomía tras cirugía abdominal de emergencia, análisis de causas y factores de riesgo. Journal of American Health [Internet]. 2022 [citado 28/09/2024];5(2). Disponible en: https://jah-journal.com/index.php/jah/article/view/136
Guerra Macías I, Castañeda Urdaneta F, Cutié Taquechel G. Perfil clínico, quirúrgico y epidemiológico de pacientes reintervenidos. Rev Cubana Cir [Internet]. 2021 [citado 25/10/2024];60(4). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932021000400008&lng=es
Ferreira e Pereira EB, Santos de Souza JH, de Araújo Sousa TD, et al. Ocurrencia de laparotomía de eme rgencia y factores de riesgo asociados a la relaparotomía. RUE [Internet]. 2022 [citado 27/09/2024];17(1):e2022v17n1a3. Disponible en: https://rue.fenf.edu.uy/index.php/rue/article/view/333
Cruz Jordán V, Miñan Arana F. Factores de Riesgo Asociados a las Relaparotomías no Programadas en Pacientes Tratados Quirúrgicamente por el Servicio de Cirugía General del Hospital de Especialidades de Guayaquil “Dr. Abel Gilbert Pontón”. Revista Especialidades HAGP [Internet]. 2023 [citado 27/09/2024];1. Disponible en: https://revista.hospitalguayaquil.gob.ec:9092/index.php/revista/article/download/6/21/38
Abebe K, Geremew B, Lemmu B, et al. Indications and Outcome of Patients who had Re-Laparotomy: Two Years’ Experience from a Teaching Hospital in a Developing Nation. Ethiop J Health Sci. 2020;30(5). DOI: 10.4314/ejhs.v30i5.13.
Ugumba CS, Kasong MK, Kaoma Cabala VdP, et al. Study of Prognostic Risk Factors for Relaparotomy in University Hospitals of LUBUMBASHI: Analysis of Biological and Terapéutico Clinical Criteria. Act Scie Medic Sci [Internet]. 2022 [citado 27/09/2024];6(7):21-7. Disponible en: https://actascientific.com/ASMS/pdf/ASMS-06-1305.pdf
Soler Morejón CD, Tamargo Barbeito TO, Pérez Mayo JC, et al. Validez de tres procedimientos para la predicción de reoperación en cirugía abdominal: estudio de cohorte. Rev Cubana Med Milit [Internet]. 2020 [citado 27/09/2024];49(4):e0200760. Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/760
Awad S, El-Rahman AIA, Abbas A, et al. The assessment of perioperative risk factors of anastomotic leakage after intestinal surgeries; a prospective study. BMC Surg. 2021;21(29). DOI: 10.1186/s12893-020-01044-8.
Calas Rodríguez A, Pérez Assef H, Araujo Pradere LJ. Peritonitis terciaria como reto para los cuidados intensivos. Rev Cubana Cir [Internet]. 2021 [citado 27/09/2024];60(4). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932021000400010&lng=es
Amentie E, Beyene B, Sisay M, et al. Magnitude of early relaparotomy and its outcome among patients who underwent laparotomy in a tertiary hospital in Eastern Ethiopia: a cross- sectional study. BMC Surg. 2024;24(51). DOI: 10.1186/s12893-024-02338-x.
Zala JN, Badami K, Jivani S, et al. Observational clinical study of indications and outcome of re-exploration laparotomy in 50 patients. Int Surg J. 2022;9(11):1830-4. DOI: 10.18203/2349-2902.isj20222937.
Swallow AY, Akoko LO, Lema LE. Patient’s characteristics, management practices and outcome of re-laparotomies in a tertiary hospital in Tanzania. Heliyon. 2020;6(7). DOI: 10.1016/j.heliyon.2020.e04295.
Yucra Callo RS. Factores asociados a relaparotomía en el servicio de Cirugía General del Hospital Antonio Lorena del Cusco, 2015 – 2023 [tesis en Internet]. Cusco: Universidad Nacional de San Antonio Abad del Cusco; 2024 [citado 27/09/2024]. Disponible en: http://repositorio.unsaac.edu.pe/handle/20.500.12918/9089
García Gutiérrez AI. Exceso de base en pacientes con cirugía abdominal mayor, como factor predictivo de complicaciones [tesis en Internet]. Carabobo: Universidad de Carabobo [Internet]; 2015 [citado 19/10/2024]. Disponible en: http://mriuc.bc.uc.edu.ve/handle/123456789/2822
La Rosa Armero Y, Rodríguez Fernández Z, Matos Tamayo ME. El dilema de las reintervenciones quirúrgicas. Rev Cubana Cir [Internet]. 2019 [citado 27/09/2024];57(4). Disponible en: https://revcirugia.sld.cu/index.php/cir/article/view/708
Quintero Infante A, Díaz Mayo J, Laurencio Vargas Y, et al. Pacientes con cirugía abdominal. Rev Cubaana Med Int Emerg [Internet]. 2018 [citado 25/10/2024];17(4). Disponible en: https://revmie.sld.cu/index.php/mie/article/view/426
Encalada JF, Campelos P, Delgado C, et al. Reintervenciones en una Unidad de Cuidados Intensivos de Cirugía Cardiovascular. Cir Esp. 2016;94(4):227-31. DOI: 10.1016/j.ciresp.2015.07.004.
Espinoza R, Espinoza JP. Calidad en cirugía: hacia una mejor comprensión de las complicaciones quirúrgicas. Rev Méd Chile [Internet]. 2016 [citado 25/10/2024];144(6):752-7. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016000600010&lng=es
Cintra Pérez D, Cintra Brooks D, Ramírez Robert D, et al. Técnica de abdomen abierto en el servicio de Cirugía del Hospital General Docente “Dr. Agostinho Neto” de Guantánamo. Rev Inf Cient [Internet]. 2014 [citado 25/10/2024];86(4). Disponible en: https://revinfcientifica.sld.cu/index.php/ric/article/view/1053
Hernández Ruiz A, Vinent Llorente JA, Delgado Fernández RI, et al. Factores que influyen en la mortalidad en los pacientes graves con cirugía abdominal. Rev Cubana Cir [Internet]. 2014 [citado 25/10/2024];53(2):134-44. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932014000200003&lng=es
González Yovera JG, Díaz Saraza PD. Características epidemiológicas, clínicas y quirúrgicas de pacientes sometidos a relaparotomía, en el Hospital Base Almanzor Aguinaga Asenjo de Chiclayo 2014-1016 [tesis en Internet]. Lambayeque: Universidad Nacional Pedro Ruiz Gallo; 2017 [citado 25/10/2024]. Disponible en: https://repositorio.unprg.edu.pe/handle/20.500.12893/926
Soria-Aledo V, Angel-Garcia D, Martinez-Nicolas I, et al. Desarrollo y estudio piloto de un conjunto esencial de indicadores para los servicios de cirugía general. Cir Esp. 2016;94(9):502-10. DOI: 10.1016/j.ciresp.2016.06.009.
Cordero Escobar I. Factores predictores de sepsis posoperatoria en pacientes intervenidos de cirugía de urgencia. Rev Cubana Med Int Emerg [Internet]. 2023 [citado 27/09/2024];22(4). Disponible en: https://revmie.sld.cu/index.php/mie/article/view/992
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