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

Purpose

Childhood typhoid ileal perforation is associated with high morbidity and mortality. Our aim was to ascertain the predictors of survival in children.

Materials and methods

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.

Results

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).

Conclusion

The patients’ age and postoperative burst abdomen were significant determinants of survival in children with typhoid ileal perforation.