BACKGROUND: Early classification of patients presenting with peritonitis and intra-abdominal sepsis by means of objective scoring systems is desirable to select patients for 'aggressive' surgery and to compare results of different treatment regimens. However, none of the existing scoring systems has fulfilled all expectations. METHODS: Evaluation of the value of various scoring systems (Acute Physiology And Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score, Sepsis Severity Score, Multiple Organ Failure, Mannheim Peritonitis Index (MPI), Ranson and Imrie) was performed in 50 patients. Additionally, scoring systems were combined to obtain a 'combined score' for the prediction of peritonitis-related in-hospital death. Hazard ratios were calculated in a univariate and multivariate analysis. RESULTS: In the univariate analysis all scoring systems, except Ranson and Imrie, predicted the primary outcome. In the multivariate analysis, only the APACHE II score (hazard ratio 6.7) and the MPI (hazard ratio 9.8) contributed independently to the prediction of outcome. All patients with an APACHE II score of 20 or more and a MPI of 27 or more died in hospital. CONCLUSION: Combination of the APACHE II and the MPI provides the best scoring system fitting clinical goals.
BACKGROUND: Early classification of patients presenting with peritonitis and intra-abdominal sepsis by means of objective scoring systems is desirable to select patients for 'aggressive' surgery and to compare results of different treatment regimens. However, none of the existing scoring systems has fulfilled all expectations. METHODS: Evaluation of the value of various scoring systems (Acute Physiology And Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score, Sepsis Severity Score, Multiple Organ Failure, Mannheim Peritonitis Index (MPI), Ranson and Imrie) was performed in 50 patients. Additionally, scoring systems were combined to obtain a 'combined score' for the prediction of peritonitis-related in-hospital death. Hazard ratios were calculated in a univariate and multivariate analysis. RESULTS: In the univariate analysis all scoring systems, except Ranson and Imrie, predicted the primary outcome. In the multivariate analysis, only the APACHE II score (hazard ratio 6.7) and the MPI (hazard ratio 9.8) contributed independently to the prediction of outcome. All patients with an APACHE II score of 20 or more and a MPI of 27 or more died in hospital. CONCLUSION: Combination of the APACHE II and the MPI provides the best scoring system fitting clinical goals.
Authors: Renato Costi; François Cauchy; Alban Le Bian; Jean-François Honart; Nicolas Creuze; Claude Smadja Journal: Surg Endosc Date: 2012-01-25 Impact factor: 4.584
Authors: Emilia Cercenado; Luis Torroba; Rafael Cantón; Luis Martínez-Martínez; Fernando Chaves; Jose Angel García-Rodríguez; Carmen Lopez-Garcia; Lorenzo Aguilar; César García-Rey; Nuria García-Escribano; Emilio Bouza Journal: J Clin Microbiol Date: 2009-11-25 Impact factor: 5.948
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: Sebastiaan Weijer; Miguel E Sewnath; Alex F de Vos; Sandrine Florquin; Koen van der Sluis; Dirk J Gouma; Kiyoshi Takeda; Shizuo Akira; Tom van der Poll Journal: Infect Immun Date: 2003-10 Impact factor: 3.441