Association of Postoperative Hyperbilirubinemia and Infection Among Patients Undergoing Emergency Exploratory Laparotomy for Gastrointestinal Perforation at Tertiary Care Hospital Karachi: Postoperative Hyperbilirubinemia and Infection in Emergency Laparotomy for GI Perforation

Qurrat Ul Ain Arshad; Shireen Sabir Ansari; Maida Naeem; Shakila Jhatial; Maleeha Khan Lodhi; Irfan Tariq Keen; Deema Sabtan

doi:10.54393/pjhs.v6i11.3555

Authors

Qurrat Ul Ain Arshad Department of Breast Surgery, Liaquat National Hospital, Karachi, Pakistan
Shireen Sabir Ansari Department of General Surgery, Bahria University of Health Sciences, Karachi, Pakistan
Maida Naeem Department of General Surgery, Taluka Hospital Digri, Mirpurkhas, Pakistan
Shakila Jhatial Department of Breast Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
Maleeha Khan Lodhi Department of Breast Surgery, Liaquat National Hospital, Karachi, Pakistan
Irfan Tariq Keen Department of Vascular Surgery, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, Pakistan
Deema Sabtan Department of Pathology, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia

DOI:

https://doi.org/10.54393/pjhs.v6i11.3555

Keywords:

Gastrointestinal Tract, Perforation, Hyperbilirubinemia, Exploratory Laparotomy, Postoperative Infection, Mortality

Abstract

Patients presenting to the surgery emergency room complaining of severe abdominal discomfort are often patients with gastrointestinal perforations. In the developing world, there are differences in incidence, site of perforation, aetiology, and demographics. Because of the distinct pathophysiologies associated with elevated levels of direct bilirubin (D-Bil) and indirect bilirubin (I-Bil), the consequences related to these two forms of bilirubin are likewise distinct. Objectives: To determine the association of postoperative hyperbilirubinemia and infections among patients undergoing emergency exploratory laparotomy for gastrointestinal perforation at Tertiary Care Hospital, Karachi. Methods: This prospective cohort study utilized a non-probability convenience sample in a one-year cohort study that took place at the Department of Surgery, Dr. Ruth K.M. Pfua Civil Hospital in Karachi. The SPSS software (version 26) was used for data processing. The t-test was applied, and the p-value was determined to be less than or equal to 0.05. Results: Postoperative infection showed that in the patients who were in the exposed and unexposed groups, 24 (48%) and 15 (30%) had postoperative infection. P-value was 0.006 with a relative risk of 1.60. Mortality showed that in the patients who were in the exposed and unexposed group, 13 (26%) and 02 (4%) had mortality. P-value was 0.001 and a margin of relative risk 6.50. Conclusions: The results show that patients with GI perforation who experience postoperative hyperbilirubinemia are more likely to have persistent postoperative infection and have a worse prognosis.

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