The emergency abdominal surgery is necessary, it is a salvage surgery, No surgery all patients have died. The high mortality is due to the difficulty and delay in diagnosis, patient or willful neglect of his medical entourage, and encountered pathologies arriving at the stage of serious complication. A voluntary care in the early symptoms would achieve surgical treatment in better conditions. The aim of our study was to determine predictive factors of mortality for emergency of non traumatic abdomino -pelvic surgical pathology of the elderly people.
PATIENTS AND METHODS:100 patients aged 65 years or more made in between January 2012 and August 2014 in the service of Surgical Intensive Care and Emergency Surgery Department dues Visceral I and II Regional Hospital ALFARRABI We analyzed patient data the reason for consultation, biological data, intraoperative diagnosis, management time , hospitalization and mortality in intensive care
RESULTS:The mean age was 74.82 years. 51 % were male and 49% were women. 65 had comorbidities, 31 had an ASAscore>3 The main reason for consultation was suspicion of an occlusive syndrome (42%).The most common surgical indications were for bowel obstruction (38%), followed by strangulated hernia (15%). 64 patients (64%) have been made after more than 6 hours. 26 were hospitalized in ICU. 15 deaths were observed an overall mortality of 15%. The main cause of death was septic shock Univariate analysis showed that age, ASA score , Charlson index , POSSUM score , are independent risk factors mortalité.L’analyse multivariate logistic regression showed that the physiological PPSOM score predictive of mortality by adjusting the management of time and hospitalization in ICU (OR = 1.15, 95% CI = [ 1.01-1.31 ] , p = 0.03) .
CONCLUSION:Mortality in subjects aged after emergency abdominal surgery is associated with several factors thus a more voluntary care in the early symptoms would achieve surgical treatment in better conditions