Predictors of mortality in children with typhoid ileal perforation in a Nigerian tertiary hospital.

Abstract

Childhood typhoid ileal perforation is associated with high morbidity and mortality. Our aim was to ascertain the predictors of survival in children. This is a tertiary hospital-based retrospective review of patients aged ≤15 years managed for typhoid ileal perforations between January 2005 and December 2013. The details of their biodata, potential risk factors and outcome were evaluated. Forty-five children out of a total of 97 with typhoid fever had typhoid ileal perforation. The age range was 2-15 years, mean (±SD) = 9.3 (±3.31) years, median = 10 years. There were more males than females (26:19). Thirty-nine (86.7%) patients were >5 years old. There were nine deaths (20% mortality). The mean (±SD) age of survivors was 9.8 (±2.9) years and 7.1 (±4.2) for non-survivors (p = 0.026). The duration of illness at presentation, gender, admission temperature, nutritional status and packed cell volume, perforation-operation interval, number of perforations, surgical procedure, and the duration of surgery did not statistically influence survival (p > 0.05). The age of the patients and burst abdomen attained statistical significance (p < 0.05). The patients' age and postoperative burst abdomen were significant determinants of survival in children with typhoid ileal perforation.