Predicting Mortality and Length of Stay After Laparotomy for Intra-Abdominal Infection: The Role of Physical Examination and Antimicrobial Susceptibility
DOI:
https://doi.org/10.46799/adv.v4i10.703Keywords:
intra-abdominal infection, laparotomy, physical examination, antimicrobial susceptibilityAbstract
Intra-abdominal infection (IAI) is a surgical emergency associated with high mortality and poor clinical outcomes. This study aimed to analyze the associations of abdominal physical examination findings, vital signs, and antimicrobial susceptibility with clinical outcomes, specifically mortality and length of stay (LOS), in patients undergoing laparotomy for IAI. This retrospective observational cohort study included 60 patients with IAI treated at RSUD Dr. R. Soedjati Soemodiardjo Purwodadi Grobogan between January 2024 and December 2025. Data were extracted from medical records and analyzed using univariate, bivariate, and multivariable analyses, with statistical significance set at p < 0.05. The mortality rate was 26.7%, and the median LOS was 6 days. Bivariate analysis showed that abdominal distension, mean arterial pressure (MAP), heart rate, respiratory rate, body temperature, and oxygen saturation were significantly associated with mortality (p < 0.05). MAP and body temperature were also significantly associated with LOS. Abdominal guarding and extended-spectrum beta-lactamase (ESBL) status were not significantly associated with either clinical outcome. In the multivariable analysis, preoperative length of stay emerged as an independent predictor of prolonged LOS (p < 0.001), whereas no independent predictor of mortality was identified. Physical examination findings, particularly abdominal distension, together with vital signs, were important early clinical parameters associated with mortality and LOS in patients undergoing laparotomy for IAI.
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