Title : Descriptive and correlational study of peritonitis in the surgical department of the state university hospital of Haiti (Hueh): A cross sectional study
Abstract:
Background: Generalized secondary peritonitis is one of the most common emergencies encountered in the surgical department. It is a major surgical condition with mortality of up to 20% and classified as the third most common cause of surgical abdomen after appendicitis and intestinal obstruction. In Haiti, few studies on surgical pathology are available.
Materials and methods: This is a correlational descriptive study carried out in the State University Hospital of Haiti (HUEH) surgery department over 6 years (2013-2018) with a sample of 91 patients.
Results: The mean patient age was 27.29 years (±13.28). The 3 most common diagnoses were appendicular peritonitis (48.35%), typhoid peritonitis (18.68%), and gastric perforation peritonitis (10.99%). Delays were more substantial for women than men (5.18 vs. 2.89 days, for the pre-operative period; 11.79 vs. 7.68 days, for the post-operative period, and 16.97 vs. 10.47 days, for duration of hospital stay). The mean MPI score is 23.3, and was an association between MPI severity score with age (r=0.37; p=0.002), pre-op duration (r=0.28, p= 0.024) and duration of hospital stay (r=0.24; p=0.046). Multiple linear regression revealed that only creatininemia, pre-op duration, and age influence the severity score. Thus, we observed a strong correlation between these 3 variables and the MPI score (r=0.69), with 48.7% of the score variation being influenced by these 3 variables (p=0.014).
Conclusion: Peritonitis is a disease mainly of young adult males, and the predominant etiology is appendicular peritonitis. Management is urgent, but delays in care are important and are correlated to the severity of the disease, potentially affecting outcomes for patients who need treatment the most.
Audience Take Away Notes:
- This work will make it possible to understand the challenge in the management of peritonitis in a low-resource country like Haiti.
- Through this work we will show the importance of the use of the MPI severity score and the demographics and clinical factors that can influence this score always in a difficult context with limited means, and to see how it can help in reducing mortality associated with peritonitis.
