Risk factors and predictors of mortality in cases of on-demand relaparotomy due to complicated intraperitoneal Sepsis: a prospective study

Background: Relaparotomy patients burden healthcare systems, especially in low-income centers. With over occupying ICU beds at the hospital, numerous patients were not admitted to the ICU despite multiple surgeries and adverse events requiring strict supervision, so in this study we aimed to determine the risk factors and predictors of mortality in patients who underwent on-demand re-laparotomy (OD) due to complicated intraperitoneal sepsis. Methods: A total of 113 patients who needed re-laparotomy for complicated intraperitoneal sepsis were included in the study. Patients who underwent planned re-laparotomy (PR) or were re-explored laparoscopically were excluded. We followed with laboratory and radiological investigations to evaluate improvement, wound infection, anastomotic leakage, hemorrhage, burst abdomen, surgical re-exploration and mortality. Results: Mortality was greater in males (87.9 %), patients with chronic kidney disease (12.1 %), patients with coronavirus disease 2019 (27.3 %), patients with a negative surgical history of previous abdominal surgery, and patients with a presentation of acute abdomen (60.6 %). There were statistically significant differences between survived and mortality cases in terms of the procedure, operative findings, surgical site, preoperative shock, surgical procedure, admission to the ICU, and outcome of the intervention. Multi-organ failure Conclusion: Our study revealed the following factors are predictors of mortality in patients who needed OD due to complicated intraperitoneal sepsis: , pre-re-exploration shock, a time since primary surgery 7 days or more, the operative finding of mesenteric vascular occlusion and intestinal gangrene, intestinal