Prognostic Indicators and Short Term Outcomes for Operated Patients with Peritonitis: Prospective Cohort Hospital Based Study in Northern Tanzania

Abstract Background: Peritonitis is one of the most common surgical emergencies all over the world and is associated with significant complications and mortality. The spectrum of aetiology of peritonitis differs between high income countries and low income countries. Majority of the patients present late with purulent peritonitis and septiceamia. Surgical treatment of peritonitis is highly demanding and very complex, however, if the outcome in these patients can be correctly predicted, then better management can be instituted in order to achieve optimal patients’ care and hence improve treatment outcome.Methods: Prospective cohort hospital based study was conducted among patients admitted due to peritonitis at Kilimanjaro Christian medical center (KCMC) from October 2018 to March 2019.Documentary review and interview methods were employed to obtain data using electronic structured questionnaire. Data was summarized using median, Inter-quartile range (IQR), frequency and percentage. Both bivariate and multivariate logistic regression analyses were used to identify prognostic indicators for post-operative complications and mortality. A 95% CI and P <0.05 used for significance test.Results: The study enrolled 70 patients with predominance of male, giving a male to female ratio of 4.1:1. A total number of 33(47.1%) developed complications and 16(22.9%) died. Only 1(1.43%) patient presented to the hospital within 24 hours since the onset of illness. Delay in care, longer duration of operation, and low potassium were the prognostic indicators noted to have influence on short term complications. The major influence for mortality were comorbidity (AOR=3.02; 95%CI: 2.25-42.90) and postoperative complications (dyselectrolaemia) with (AOR=9.27; 95%CI: 1.21-70.83).Conclusion: Mortality and complications resulted from peritonitis is unacceptably high. Delay in care, longer duration of operation and preoperative low serum potassium levels were the prognostic indicators for the post-operative complications. Comorbidity and postoperative complications such as dyselectrolaemia had influence for the mortality. Correct prediction of these adverse outcomes will help to institute better management for the patients with peritonitis.