Epidemiology, management, and prognosis of secondary non-postoperative peritonitis: a French prospective observational multicenter study.

Abstract Background: Despite improvements in treatment, secondary peritonitis still is associated with high morbidity and mortality rates. Better knowledge of real-life clinical practice might improve management. Methods: Prospective, observational study (January–June 2005) of 841 patients with non-postoperative secondary peritonitis. Results: Peritonitis originated in the colon (32% of patients), appendix (31%), stomach/duodenum (18%), small bowel (13%), or biliary tract (6%). Most patients (78%) presented with generalized peritonitis and 26% with severe peritonitis (Simplified Acute Physiology Score [SAPS] II score > 38). Among the 841 patients, 27.3% underwent laparoscopy alone; 11% underwent repeat surgery, percutaneous drainage, or both. A SAPS II score > 38 and the presence of Enterococcus spp. were predictive of abdominal and non-surgical infections (odds ratio [OR] = 1.84; p = 0.013 and OR = 2.93; p 38 also was predictive of death (OR = 10.5; p < 0.0001)....