World Journal of Surgery

, 33:34 | Cite as

Prognostic Factors in Critically Ill Patients Suffering from Secondary Peritonitis: A Retrospective, Observational, Survival Time Analysis

  • Christian P. Schneider
  • Carol Seyboth
  • Markus Vilsmaier
  • Helmut Küchenhoff
  • Benjamin Hofner
  • Karl-Walter Jauch
  • Wolfgang H. HartlEmail author



Acute mortality of unselected critically ill patients has improved during the last 15 years. Whether these benefits also affect survival of critically ill patients with secondary peritonitis is unclear as is the relevance of specific prognostic factors, such as source control.


We performed a retrospective analysis of data collected prospectively from March 1993 to February 2005. A cohort of 319 consecutive postoperative patients with secondary peritonitis requiring intensive care was evaluated. End points for outcome analysis were derived from daily changes of hazard rate.


Four-month survival rate after intensive care unit (ICU) admission was 31.7%. For patients who have survived for more than 4 months, the 1-year survival was 82.7%. After adjustment for relevant covariates, a high disease severity at ICU admission and during ICU stay, specific comorbidities (extended malignancies, liver cirrhosis) and sources of infection (distal esophagus, stomach), and an inadequate initial antibiotic therapy were associated with worse 4-month prognosis. Inability to obtain source control was the most important determinant of mortality, and treatment after 2002 was combined with improved prognosis.


Four-month prognosis of critically ill, surgical patients with secondary peritonitis is poor and mostly determined by the ability to obtain source control. Outcome has improved since 2002, and after successful surgical and intensive care therapy long-term survival seems to be good.


Intensive Care Unit Peritonitis Intensive Care Unit Admission Intensive Care Unit Stay Empiric Antibiotic Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank D. Inthorn and H. Schneeberger for initiation and maintenance of the database.


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Copyright information

© Société Internationale de Chirurgie 2008

Authors and Affiliations

  • Christian P. Schneider
    • 1
  • Carol Seyboth
    • 1
  • Markus Vilsmaier
    • 1
  • Helmut Küchenhoff
    • 2
  • Benjamin Hofner
    • 2
  • Karl-Walter Jauch
    • 1
  • Wolfgang H. Hartl
    • 1
    Email author
  1. 1.Department of SurgeryKlinikum GrosshadernMunichGermany
  2. 2.Statistical Consulting Unit, Department of StatisticsLudwig-Maximilian Universität München MunichGermany

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