BACKGROUND AND AIMS: Tertiary peritonitis is a severe persisting intra-abdominal infection and associated with high mortality. The aim was to find significant risk factors for mortality and tertiary peritonitis including the Mannheim Peritonitis Index (MPI), the Acute Physiology and Chronic Health Evaluation (APACHE) II score, and a sumscore of both. MATERIALS AND METHODS: In this retrospective single-center cohort study, 122 patients were treated at the Surgical Department of a University Hospital. RESULTS: Sixty-nine patients (56.6%) developed tertiary peritonitis. Nineteen patients (27.5%), who suffered from tertiary peritonitis, died in contrast to eight patients (15.1%) with secondary peritonitis (P = 0.101). Patients with tertiary peritonitis had significantly higher APACHE II (P < 0.001), MPI (P = 0.035), and combined APACHE II and MPI scores (P < 0.001) than patients with secondary peritonitis. Age (P = 0.035), fungal infections (P = 0.025), and infections with more than one microbial organism (P = 0.047) were predictive for tertiary peritonitis. Combined APACHE II and MPI scores detected tertiary peritonitis better than the MPI (P = 0.014). Detection of mortality was comparable in all evaluated prognostic scores. CONCLUSION: Prognostic scores besides age and fungal infections are risk factors for mortality and help to differentiate between secondary and tertiary peritonitis. The combination of prognostic scores is comparable to the APACHE II and superior compared to the MPI in regard to detection of tertiary peritonitis.
BACKGROUND AND AIMS: Tertiary peritonitis is a severe persisting intra-abdominal infection and associated with high mortality. The aim was to find significant risk factors for mortality and tertiary peritonitis including the Mannheim Peritonitis Index (MPI), the Acute Physiology and Chronic Health Evaluation (APACHE) II score, and a sumscore of both. MATERIALS AND METHODS: In this retrospective single-center cohort study, 122 patients were treated at the Surgical Department of a University Hospital. RESULTS: Sixty-nine patients (56.6%) developed tertiary peritonitis. Nineteen patients (27.5%), who suffered from tertiary peritonitis, died in contrast to eight patients (15.1%) with secondary peritonitis (P = 0.101). Patients with tertiary peritonitis had significantly higher APACHE II (P < 0.001), MPI (P = 0.035), and combined APACHE II and MPI scores (P < 0.001) than patients with secondary peritonitis. Age (P = 0.035), fungal infections (P = 0.025), and infections with more than one microbial organism (P = 0.047) were predictive for tertiary peritonitis. Combined APACHE II and MPI scores detected tertiary peritonitis better than the MPI (P = 0.014). Detection of mortality was comparable in all evaluated prognostic scores. CONCLUSION: Prognostic scores besides age and fungal infections are risk factors for mortality and help to differentiate between secondary and tertiary peritonitis. The combination of prognostic scores is comparable to the APACHE II and superior compared to the MPI in regard to detection of tertiary peritonitis.
Authors: Héctor Orozco; Jorge Arch; Heriberto Medina-Franco; Juan P Pantoja; Quintín H González; Mario Vilatoba; Carlos Hinojosa; Florencia Vargas-Vorackova; José Sifuentes-Osornio Journal: Arch Surg Date: 2006-02
Authors: Anthony W Chow; Gerald A Evans; Avery B Nathens; Chad G Ball; Glen Hansen; Godfrey Km Harding; Andrew W Kirkpatrick; Karl Weiss; George G Zhanel Journal: Can J Infect Dis Med Microbiol Date: 2010 Impact factor: 2.471
Authors: Hanna Santos Marques; Glauber Rocha Lima Araújo; Filipe Antônio França da Silva; Breno Bittencourt de Brito; Paulo Victor Dias Versiani; Jaqueline Silva Caires; Thiago de Carvalho Milet; Fabrício Freire de Melo Journal: World J Clin Cases Date: 2021-04-06 Impact factor: 1.337