Muzaffar Aziz, Abdul Qadir, Muzammil Aziz, Faizullah.
Prognostic factors in typhoid perforation.
J Coll Physicians Surg Pak Jan ;15(11):704-7.

Objective: To discuss the effect of duration of illness before perforation and time interval between perforation and surgery on the prognosis of typhoid perforation. Design: Comparative study. Place and Duration of Study: Nishtar Hospital, Multan from September 2002 to September 2004. Patients and Methods: Seventytwo patients of typhoid perforation were included in this study. The patients were divided into three groups A, B and C according to duration of illness before perforation. In these groups, typhoid perforation occurred during 1st, 2nd and 3rd week respectively. Further patients were divided into group D, E and F according to time interval between perforation and surgery. In these groups surgery was carried out within 24 hours, 24-48 hours and after 48 hours respectively. Results: Fiftysix patients were males and 16 were females. In groups A, B and C, mortality rate was 6.6%, 13.3% and 25%, while morbidity rate was 33.3%, 55.5% and 75% respectively. There were 12, 42 and 18 patients in Group D, E and F with mortality rate of 8.33%, 11.9% and 22.2% respectively. Group D had 41.6% morbidity rate while group E and F had 71.42% and 77.7% respectively. Conclusion: In this study, early perforation during the typhoid fever and short perforation-operation interval were good prognostic signs. So best results can be achieved by early patient`s presentation and early operation.

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