Mortality and septic score of colorectal perforation: A retrospective study of 102 patients

During the period from 1983 to 1992, 102 patients of colorectal diseases associated with perforation (traumatic, iatrogenic perforation and anastomotic leakage were excluded) were studied retrospectively. There were 81 males and 21 females with mean age of 62.1 years (rang 25-86) and 67.1 years (range 37-81) respectively. The 18 deaths yielded an overall mortality rate of 17.6% (18/102); 0% (0/26) in patients with localized peritonitis, 15.0% (6/40) in generalized purulent peritonitis and 33.3% (12/36) in generalized feculent peritonitis. Correlation of operative mortality with preoperative spesis, as defined by septic score, was analyzed with the results: in generalized purulent peritonitis, when the score was <3, the operative mortality rate was 10.5% (4/38), when the score was>=3, it reached to 100% (2/2); in feculent peritonitis when the score was<3, the mortality rate was 14.8% (4/27), when the score was>=3, it reached up to 88.9% (8/9). Furthermore, if the operative mortality rate was compared by only considering the preoperative septic score, a significant difference (P<0.05) existed: when the score was>=1, the mortality rate was 38.4% (15/39), and when the score was<1, it was 8.1% (3/37). In summary, this experience indicated that the extent of intra-abdominal contamination by bacteria or feces and severity of preoperative sepsis were major factors which significantly produced high correlation with operative mortality. Choice of the most appropriate operative procedure still depends upon the patient's clinical condition and individualized selection.