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Abstract
Objective: To determine the frequency of 30-day morbidity and mortality among patients undergoing exploratory laparotomy for typhoid ileal perforation.
Study Design: Descriptive cross-sectional study.
Setting: Department of Surgery, Jinnah Postgraduate Medical Centre, Karachi.
Period: Four months from 5th March 2025 to 15st June 2025.
Material & Methods: 157 patients aged 30 to 80 years, undergoing laparotomy for typhoid ileal perforation, were enrolled using a non-probability consecutive sampling method. Morbidity included any of the also-ascribed postoperative morbidities, while mortality was defined as death in the first 30 days after the procedure. Descriptive statistics were used to summarize quantitative variables, while frequencies and percentages were used for categorical variables. Significance level of p<=0.05 was used for planned post-stratification chi-square or Fisher exact tests.
Results: The mean age in this study was 49 years, and 66.2% were male. The median was 49 years as well, and residents were reporting an even distribution. 70.1% of participants had a monthly income < 50,000 PKR. Of the total participants, 77 developed morbidity (49.0%; 95% CI 41.3-56.8) and 25 died (15.9%; 95% CI 11.0-22.5). Both morbidity and mortality were analysed, and the following factors were assessed and found to be associated: Age > 50 years, rural vs urban residence, duration of surgery > 3 hours, and length of stay > 10 days (all with p < 0.001). However, analysis revealed that there was no significant relationship found between sex and morbidity (p = 0.310), as was found between sex and mortality (p = 0.260).
Conclusion: Typhoid ileal perforation had significant morbidity and mortality at 30 days. The recognition of high-risk patients and the use of uniformly standardized peroperative pathways may produce better outcomes.