Predictors of the Mortality of Patients Under Anesthesia for Postoperative Peritonitis in Kinshasa

Background: Anesthesia for postoperative peritonitis is associated with significant mortality due to the risk of multiorgan failure. This study was conducted to find predictors of this mortality.

Methods: This is a multicenter documentary analytical study conducted from 01/01/2017 to 12/31/2021 in patients anesthetized for postoperative peritonitis. Sociodemographic, clinical, and evolutionary data were collected and analyzed with SPSS 23.0 using, depending on the type of data; t Student, chi-square and Fischer’s exact tests, logistic regression and Kaplan Meir curves for p˂0.05.

Results: Two hundred and one patients were included in the study, the average age was 30 years (SD: 19); there were more or less as many men as women (sex ratio 0.97); 28.4% had comorbidities; 62.7% were transferred from peripheral structures, of which 57.7% were operated on urgently with appendicitis as the main indication (30.8%); surgery performed by a junior in 59.2%. The mean recovery time was 10.25 days; consciousness was altered perioperatively in 30.3%; 58.2% were classified as ASA III; 33.8% ASA IV; all the patients were operated under general anesthesia with tracheal intubation using the association propofol-ketamine, suxamethonium, halogenated and fentanyl. Antibiotic therapy was empirical using the combination of C 3 G-Metronidazole (44.3%) and Piperacillin/tazobactam-aminoside (30.3%), complications were present intraoperatively in 55.2% and postoperatively in 41.8%; 5.5% irreversible cardiorespiratory arrest on induction. The overall mortality was 37.7%. Age > 65 years, ASA class > 3, impaired consciousness and the occurrence of intraoperative complications have proven to be predictors of mortality.

Conclusion: Mortality in this series, although significant, is low compared to previous studies and its predictors depend more on the patient’s condition and are relatively independent of anesthesia.

Keywords: Predictors, Mortality, Anesthesia, Postoperative peritonitis.