Postoperative hyperbilirubinemia after surgery for gastrointestinal perforation

The aim of this study was to evaluate the risk factors and outcome of patients with hyperbilirubinemia after surgery for generalized peritonitis. We retrospectively analyzed data from 229 patients with generalized peritonitis caused by gastrointestinal (GI) perforations. Postoperative hyperbilirubin...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2002-01, Vol.32 (8), p.679-684
Main Authors: Nishida, Toshirou, Fujita, Nobuhiro, Megawa, Tadashi, Nakahara, Masaaki, Nakao, Kazuyasu
Format: Article
Language:English
Subjects:
Adult
Female
Humans
Hyperbilirubinemia - etiology
Hyperbilirubinemia - mortality
Intestinal Perforation - etiology
Intestinal Perforation - surgery
Male
Middle Aged
Nutritional Status
Peritonitis - surgery
Postoperative Complications - mortality
Prognosis
Retrospective Studies
Risk Factors
Stomach Diseases - etiology
Stomach Diseases - surgery
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Summary:The aim of this study was to evaluate the risk factors and outcome of patients with hyperbilirubinemia after surgery for generalized peritonitis. We retrospectively analyzed data from 229 patients with generalized peritonitis caused by gastrointestinal (GI) perforations. Postoperative hyperbilirubinemia defined as a value of > or =5 mg/dl, within 1 month, developed in 39 patients. Postoperative hyperbilirubinemia was related to age ( P = 0.0102), poor nutritional status ( P = 0.0388), decreased base excess ( P = 0.0037), delay until surgery ( P = 0.0276), preoperative serum bilirubin ( P = 0.0321) and postoperative persistent infection ( P < 0.0001). Higher mortality was seen in patients with hyperbilirubinemia (59%) than in those without hyperbilirubinemia (4%). The patients with hyperbilirubinemia who survived had decreased serum bilirubin levels after 3-5 postoperative days whereas a continuous increase was seen in the patients who ultimately died. Preoperative shock ( P = 0.0003), a decreased preoperative platelet count ( P = 0.0152), postoperative infection ( P = 0.0050), and postoperative hyperbilirubinemia ( P < 0.0001) were risk factors for overall mortality. These results indicate that postoperative hyperbilirubinemia in patients with GI perforation is related to persistent postoperative infection and associated with poor prognosis.
ISSN:0941-1291
1436-2813
DOI:10.1007/s005950200126