A study on Prevalence, Etiological and Prognostic Factors, and Clinical Medical Management of Septic Peritonitis in Femoral neck Fracture in a Tertiary Care Hospital of Haldia, West Bengal: A Cross-Sectional Study

Abstract

Background: Septic peritonitis is a severe intra-abdominal infection associated with high morbidity and mortality. It often arises from gastrointestinal perforations, appendicitis, or postoperative complications, requiring rapid diagnosis and intervention. Objective: To determine the prevalence, etiological factors, prognostic indicators, and clinical medical management of septic peritonitis in patients admitted to a tertiary care hospital in Haldia, West Bengal. Methods: A hospital-based cross-sectional study was conducted with 34 patients diagnosed with septic peritonitis. Data on demographic profile, risk factors, aetiology, prognostic indicators, and management were collected. Statistical analysis included prevalence estimation, chi-square test, and odds ratio (OR). Results: The prevalence of septic peritonitis among acute abdominal emergency cases was 16.5%. The most affected age group was ≥50 years (47.1%), with male predominance (61.8%). The leading aetiologies were perforated duodenal ulcer (32.4%), appendicular perforation (23.5%), and traumatic bowel perforation (14.7%). Significant risk factors included delayed presentation (>24h) (OR=3.78, p=0.021), diabetes mellitus (OR=2.95, p=0.039), and smoking/alcohol history (OR=2.41, p=0.048). Prognostic factors included systemic sepsis, shock at admission, and multi-organ dysfunction. Clinical management involved exploratory laparotomy with peritoneal lavage (82.3%), broad-spectrum antibiotics, and intensive supportive care. Mortality was 17.6%, associated with late presentation and comorbidities. Conclusion: Septic peritonitis is a major surgical emergency with significant prevalence and mortality. Early diagnosis, prompt surgery, and risk factor control are crucial. Preventive strategies targeting ulcer disease, infection control, and early referral may improve outcomes.