A total of thirty studies were included (n=3,349) in the review; twenty-three studies where from the main search and seven additional studies were added. Of the twenty-three studies from the main search, twenty were retrospective single-centre studies and three were prospective population studies. The additional seven studies were in the majority single-centre studies with one multi-centre study.
Postoperative mortality rates: The population based studies (three studies, n=615) found postoperative mortality rates ranging from 2.5 to 4.8% (mean 3.7%); whilst the single-centre studies (20 studies, n=2,367) reported postoperative mortality rates of 0 to 6.7% (mean 2.5%). The seven additional studies (n=367) gave specific details on the surgical procedures at primary surgery, either bowel or splenectomy, reporting postoperative mortality rates ranging from 0 to 5.9% (mean 2.7%) for bowel, and a postoperative mortality rate of 8.8 to 17% for splenectomy.
Causes of death: Eleven studies specified cause of death. The most common causes of death were pulmonary embolism (25%) and surgical site infection sepsis (20.8%).