Predictive factors affecting mortality in relaparotomies

Aim: The present study was aimed to analyze the predictive factors for the mortality of relaparatomies. Materials and method: The retrospective study included 236 patients who underwent abdominal surgery and at least one subsequent relaparatomy at Dicle University School of Medicine Department of General Surgery between January 2000 and December 2011. The evaluations included age, gender, accompanying systemic diseases, procedure used in the primary surgery and its condition (emergency/elective), total amount of blood transfusion since the primary surgery, length of time between the primary surgery and relaparatomy, date of the primary surgery, preoperative parameters (albumin, platelet, hemoglobin, leukocyte, and MPV), Glasgow coma score, length of hospital stay, length of stay in intensive care unit, and presence of shock. Results: The patients comprised 165 (69.9%) men and 71 (30.1%) women. The mean age was 55.5±17.22 years (15-89). Early stage relaparatomy (i.e. within the 21 days following the primary surgery) was performed in 231 (97.8%) patients while 5 (2.2%) patients received it in the late stage (i.e. after the 21st day). Mortality rate was 13.8% (32/231) in the early stage and 80.0% (4/5) in the late stage. The patients over 50 years old had a mortality rate of 66.6% (24/36) and the ones below 50 years old had 6.0% (12/200). It can be concluded that the need for a relaparatomy and the risk of mortality could be reduced by a well-arranged primary surgery and efficient time management in handling the postoperative complications. Nevertheless, if needed, relaparatomy could be life-saving when performed at the correct time. Conclusion: The decision whether and when to perform a relaparatomy, preoperative preparation, number of laparatomies, amount of blood transfusion, and the length of period since the primary surgery are important factors for the mortality.