C Ohmann1, D H Wittmann, H Wacha. 1. Department of General and Trauma Surgery, Heinrich-Heine-University, Düsseldorf, Germany.
Abstract
OBJECTIVE: To assess the accuracy of the APACHE II score, the Mannheim Peritonitis Index (MPI), and the Peritonitis Index Altona (PIA) II in the prediction of outcome of patients with peritonitis. DESIGN: Prospective, multicentre study. SETTING: 12 Departments of Surgery in Europe. SUBJECTS: 271 Patients with peritonitis confirmed at laparatomy. INTERVENTIONS: Computation of the three scores on one set of data for each patient. MAIN OUTCOME MEASURES: The ability to predict death or survival within 30 days of operation with each of the three scores. The prediction were evaluated according to the following criteria: discriminatory ability (areas under the receiver-operator characteristic (ROC) curves relating sensitivity to specificity); sharpness (level of confidence that was associated with a prediction); and reliability (agreement between predicted and observed mortality within equidistant intervals on the scale). RESULTS: APACHE II was superior to both the MPI and PIA II in its discriminatory ability and reliability, but the MPI and PIA II made more "sharp" predictions. CONCLUSIONS: None of the three scores is of any use for predicting the outcome for individual patients. APACHE II is the current standard for assessing the severity of peritonitis.
OBJECTIVE: To assess the accuracy of the APACHE II score, the Mannheim Peritonitis Index (MPI), and the Peritonitis Index Altona (PIA) II in the prediction of outcome of patients with peritonitis. DESIGN: Prospective, multicentre study. SETTING: 12 Departments of Surgery in Europe. SUBJECTS: 271 Patients with peritonitis confirmed at laparatomy. INTERVENTIONS: Computation of the three scores on one set of data for each patient. MAIN OUTCOME MEASURES: The ability to predict death or survival within 30 days of operation with each of the three scores. The prediction were evaluated according to the following criteria: discriminatory ability (areas under the receiver-operator characteristic (ROC) curves relating sensitivity to specificity); sharpness (level of confidence that was associated with a prediction); and reliability (agreement between predicted and observed mortality within equidistant intervals on the scale). RESULTS: APACHE II was superior to both the MPI and PIA II in its discriminatory ability and reliability, but the MPI and PIA II made more "sharp" predictions. CONCLUSIONS: None of the three scores is of any use for predicting the outcome for individual patients. APACHE II is the current standard for assessing the severity of peritonitis.
Authors: J S Solomkin; S E Wilson; N V Christou; O D Rotstein; E P Dellinger; R S Bennion; R Pak; K Tack Journal: Ann Surg Date: 2001-01 Impact factor: 12.969
Authors: J A Passarell; A K Meagher; K Liolios; B B Cirincione; S A Van Wart; T Babinchak; E J Ellis-Grosse; P G Ambrose Journal: Antimicrob Agents Chemother Date: 2007-10-22 Impact factor: 5.191
Authors: Peter Panhofer; Barbara Izay; Markus Riedl; Veronika Ferenc; Martin Ploder; Raimund Jakesz; Peter Götzinger Journal: Langenbecks Arch Surg Date: 2008-03-15 Impact factor: 3.445
Authors: Celestine S Tung; Charlotte C Sun; Matthew P Schlumbrecht; Larissa A Meyer; Diane C Bodurka Journal: Gynecol Oncol Date: 2009-09-18 Impact factor: 5.482