Peritonitis
Conditions
Brief summary
The primary objective: To study the prevalence, etiology, and factors associated with the severity of peritonitis and its complications in the surgery department of the State University Hospital of Haiti. Secondary objectives: * Identify epidemiological characteristics. * Describe the main etiologies encountered in the service * Measure the time required for treatment and its consequences on the evolution of peritonitis.
Detailed description
Generalized secondary peritonitis is one of the most common emergencies encountered in surgical departments . It is a major surgical condition with a mortality of up to 20% and classified as the third most common cause of surgical abdomens after appendicitis and intestinal obstruction . Delays in surgical management are conditions that increase mortality. While early prognostic assessment of peritonitis is essential for the objective classification of the severity of the disease, the late presentation of the majority of patients to health facilities affects this situation, further complicating effective management and promoting the occurrence of complications . It has been observed that classifying the severity of peritonitis has a major contribution to decision-making and improves management. Thus, many scoring systems have been designed and successfully used to assess the severity of acute peritonitis, including: Acute physiology and chronic health evaluation (APACHE) II score, Simplified acute physiology score (SAPS), Sepsis severity score (SSS), Ranson score, Imrite score, Mannheim peritonitis index (MPI) 6. The Mannheim Peritonitis Index (MPI) is a specific score, which is highly accurate and allows clinical parameters to be easily manipulated, allowing the individual prognosis of patients with peritonitis to be predicted . In Haiti, few studies on surgical pathologies are available. And with regard to peritonitis, only two thesis works have been listed on the subject, including one carried out at the Justinian University Hospital of Cap-Haitian on 176 patients by Dr. Jacques Julmice, who presents the main etiologies of peritonitis over a 5-year period. And the other one carried out at the Albert Schweizer Hospital by Dr. Moise Aristide, still on the etiological factors of peritonitis. These two studies are carried out outside the country's metropolitan region (the most populated region) and that they only explored the different etiologies without taking into account the time required for treatment and the gravity factors of peritonitis. Therefore, our study aims to explore the demographic, clinical and etiological factors of peritonitis in the main referral hospital in the metropolitan region of the country, as well as the time required for treatment and its relationship with the severity of the disease.
Interventions
OTHEREpidemiological description
Description of the characteristics of Peritonitis in Haiti
Sponsors
Universite d'Etat d'Haiti
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
11 Years to 82 Years
Healthy volunteers
No
Inclusion criteria
Patients whose peritonitis diagnosis was made and operated on in the department during the period. Patient whose record is identified (with age, sex) with at least the clinical and etiological diagnosis identified in the operating protocol.
Exclusion criteria
Patients with incomplete records. Cases of post-operative peritonitis. Patient under 10 years of age
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Demographic Parameters | during admission | Age in years described in the admission file |
| Respiratory Rate | immediately after admission, up to 30 minutes | Respiratory rate number of cycle/min reported in the file of entry |
| Temperature | immediately after admission, up to 30 minutes | Temperature in celsius reported in the file of entry |
| Blood Pressure | immediately after admission, up to 30 minutes | Systolic Blood pressure in mmHg reported in the file of entry |
| Etiological Diagnosis | immediately post-surgery | final diagnosis retained in the operating protocol |
| Heart Rate | immediately after admission, up to 30 minutes | Heart rate number of beats/min reported in the file entry for each patients |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Delay in Pre-op | immediately post-surgery | the pre-operative time in days which describes the time between the date of the intervention and the date of admission |
| Delay in Post-op | immediately after hospitalization | the time in days between the date of the intervention and the leaving of the patient at the hospital |
| Delay in Hospital | immediately after hospitalization | the time in days between the date of admission and the date of leaving the hospital |
| Onset of Symptoms | immediately after admission | Days before coming at the hospital |
Countries
Haiti
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Population The study population is composed of all patients diagnosed, hospitalizedand operated on in the peritonitis ward during the study period. Samplingis probabilistic, simple random sampling. To estimate the sample size, weconsidered the peritonitis prevalence of an African study on the particularityof peritonitis in tropical environments, an environment that reflects our realityin ecological, demographic and epidemiological terms, namely 19% . Thestandard error rate chosen was 5%. This allows us to estimate our sample at88 with a confidence interval of 97%. Given the possibility of finding missingfiles at the State University Hospital of Haïti, our sample was adjusted to 20%(standard non-response rate). | 91 |
| Total | 91 |
Baseline characteristics
| Characteristic | Population | — |
|---|---|---|
| Age, Categorical <=18 years | 30 Participants | — |
| Age, Categorical >=65 years | 3 Participants | — |
| Age, Categorical Between 18 and 65 years | 58 Participants | — |
| Age, Continuous | 27.29 Years STANDARD_DEVIATION 13.28 | — |
| Race and Ethnicity Not Collected | — | — Participants |
| Region of Enrollment Haiti | 91 participants | — |
| Sex: Female, Male Female | 33 Participants | — |
| Sex: Female, Male Male | 58 Participants | — |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 3 / 91 |
| other Total, other adverse events | 0 / 91 |
| serious Total, serious adverse events | 21 / 91 |
Outcome results
Primary
Blood Pressure
Systolic Blood pressure in mmHg reported in the file of entry
Time frame: immediately after admission, up to 30 minutes
Population: For the other (21) patients we did not find any data relating to the systolic blood pressure.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Population | Blood Pressure | 110.93 Hg mm | Standard Deviation 14.86 |
Primary
Demographic Parameters
Age in years described in the admission file
Time frame: during admission
Primary
Etiological Diagnosis
final diagnosis retained in the operating protocol
Time frame: immediately post-surgery
Primary
Heart Rate
Heart rate number of beats/min reported in the file entry for each patients
Time frame: immediately after admission, up to 30 minutes
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Population | Heart Rate | 108.18 Beats/min | Standard Deviation 19.66 |
Primary
Respiratory Rate
Respiratory rate number of cycle/min reported in the file of entry
Time frame: immediately after admission, up to 30 minutes
Population: For the other (11) patients we did not find any data relating to the respiratory rate.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Population | Respiratory Rate | 28.58 Cycle/min | Standard Deviation 8.51 |
Primary
Temperature
Temperature in celsius reported in the file of entry
Time frame: immediately after admission, up to 30 minutes
Population: For the other (6) patients we did not find any data relating to the temperature
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Population | Temperature | 37.52 Celcius | Standard Deviation 1.1 |
Secondary
Delay in Hospital
the time in days between the date of admission and the date of leaving the hospital
Time frame: immediately after hospitalization
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Population | Delay in Hospital | 12.82 days | Standard Deviation 11.66 |
Secondary
Delay in Post-op
the time in days between the date of the intervention and the leaving of the patient at the hospital
Time frame: immediately after hospitalization
Population: We did not find information in the files on the delay in post-op for 1 patient
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Population | Delay in Post-op | 9.19 days | Standard Deviation 10.93 |
Secondary
Delay in Pre-op
the pre-operative time in days which describes the time between the date of the intervention and the date of admission
Time frame: immediately post-surgery
Population: We did not find information in the files on the delay in pre-op for 1 patient
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Population | Delay in Pre-op | 3.73 days | Standard Deviation 3.61 |
Secondary
Onset of Symptoms
Days before coming at the hospital
Time frame: immediately after admission
Population: We did not find information in the files on the onset of symptoms for 10 patients
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Population | Onset of Symptoms | 6.9 days | Standard Deviation 8.1 |