Patient Population:
(1) 112 patients with colonic perforation treated from 1979 to 1992.
(2) Diverticulitis and carcinoma were the most common etiologies for the perforation.
(3) The overall mortality was 19.6%.
(4) In 55% the perforation was covered (no leakage of pus or bowel contents into abdominal cavity).
(5) 30% of the patients had diffuse peritonitis
(6) A resection with primary anastomosis was performed 43 times; resection without restoration of the intestinal continuity was performed 53 times, including 49 Harmann procedures.
Definitions of organ failure:
(1) renal failure: creatinine clearance < 20 mL/min, or hemodialysis required
(2) circulatory failure: systolic blood pressure < 90 mm Hg with requirement for catecholamines to maintain pressure
(3) respiratory failure: requirement for respiratory ventilation
Factors associated with poor prognosis identified on univariate analysis:
(1) age > 65 years
(2) cardiopulmonary disease
(3) diffuse peritonitis
(4) septic shock
(5) reoperation
(6) organ failure
(7) Mannheim Peritonitis Index > 30
Factors associated with poor prognosis identified after logistic regression analysis:
(1) age > 65 years (relative risk 4.6)
(2) organ failure (relative risk 2.7)
(3) increase in Mannheim Peritonitis Index of 10 points (relative risk 40)
