Prognostic Significance of Simple Scoring Systems in the Prediction of Diffuse Peritonitis Morbidity and Mortality
Status PubMed-not-MEDLINE Jazyk angličtina Země Švýcarsko Médium electronic
Typ dokumentu časopisecké články
Grantová podpora
00098892
Ministry of Health, Czech Republic - conceptual development of research organization
PubMed
35454980
PubMed Central
PMC9028034
DOI
10.3390/life12040487
PII: life12040487
Knihovny.cz E-zdroje
- Klíčová slova
- ASA, ECOG, MPI, NPWT, peritonitis, qSOFA,
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Diffuse peritonitis is a serious disease. It is often addressed within urgent management of an unstable patient in shock. The therapy consists of treatment of the source of peritonitis, decontamination of the abdominal cavity, stabilization of the patient and comprehensive resuscitation care in an intensive care unit. A number of scoring systems to determine patient prognosis are available, but most of them require complex input data, making their practical application a substantial problem. OBJECTIVE: Our aim was to assess simple scoring systems within a cohort, evaluate the level of mortality, morbidity, and duration of hospital stay, followed by a comparison of the acquired data with the literature and determination of an easily implementable scoring system for use in clinical practice. MATERIAL AND METHODS: We evaluated a group of patients with diffuse peritonitis who underwent surgery in the 2015-2019 period. Medical history, surgical findings, and paraclinical examinations were used as the input for four scoring systems commonly used in practice-MPI, qSOFA, ECOG, and ASA. We compared the results between the systems and with the literature. RESULTS: Our cohort included 274 patients diagnosed with diffuse peritonitis. Mortality was 22.6%, morbidity 73.4%, with a 25.2 day average duration of hospital stay. Mortality and morbidity increased with rising MPI and qSOFA, well-established scoring systems, but also with rising ASA and ECOG, similarly to MPI and qSOFA. CONCLUSIONS: The utilized scoring systems correlated well with the severity of the condition and with predicted mortality and morbidity as reported in the literature. Simple scoring systems primarily used in other indications (i.e., ASA and ECOG) have a similar predictive value in our cohort as commonly used systems (MPI, qSOFA). We recommend them in routine clinical practice due to their simplicity.
Zobrazit více v PubMed
Clements T.W., Tolonen M., Ball C.G., Kirkpatrick A.W. Secondary Peritonitis and Intra-Abdominal Sepsis: An Increasingly Global Disease in Search of Better Systemic Therapies. Scand. J. Surg. 2021;110:139–149. doi: 10.1177/1457496920984078. PubMed DOI
Calandra T., Cohen J. International Sepsis Forum Definition of Infection in the ICU Consensus Conference. The international sepsis forum consensus conference on definitions of infection in the intensive care unit. Crit. Care Med. 2005;33:1538–1548. doi: 10.1097/01.CCM.0000168253.91200.83. PubMed DOI
Špička P., Gryga A., Malý T., Neoral Č. Current management of diffuse peritonitis—Is postoperative continuous lavage still a relevant method of choice? Rozhl. Chir. 2019;98:18–22. (In English) PubMed
Schwarz A., Bölke E., Peiper M., Schulte am Esch J., Steinbach G., van Griensven M., Orth K. Inflammatory peritoneal reaction after perforated appendicitis: Continuous peritoneal lavage versus non lavage. Eur. J. Med. Res. 2007;12:200–205. PubMed
Winkeltau G., Winkeltau G.U., Klosterhalfen B., Niemann H., Treutner K.H., Schumpelick V. Differenzierte chirurgische Therapie der diffusen Peritonitis [Differential surgical therapy in diffuse peritonitis] Chirurg. 1992;63:1035–1040. (In German) PubMed
Bleszynski M.S., Chan T., Buczkowski A.K. Open abdomen with negative pressure device vs primary abdominal closure for the management of surgical abdominal sepsis: A retrospective review. Am. J. Surg. 2016;211:926–932. doi: 10.1016/j.amjsurg.2016.01.012. PubMed DOI
Karki O.B., Hazra N.K., Timilsina B., Kunwar D. Effectiveness of Mannheim Peritonitis Index in Predicting the Morbidity and Mortality of Patients with Hollow Viscus Perforation. Kathmandu Univ. Med. J. (KUMJ) 2018;16:296–300. PubMed
Tolonen M., Sallinen V., Mentula P., Leppäniemi A. Preoperative prognostic factors for severe diffuse secondary peritonitis: A retrospective study. Langenbecks Arch. Surg. 2016;401:611–617. doi: 10.1007/s00423-016-1454-8. PubMed DOI
Malik A.A., Wani K.A., Dar L.A., Wani M.A., Wani R.A., Parray F.Q. Mannheim Peritonitis Index and APACHE II--prediction of outcome in patients with peritonitis. Turk. J. Trauma Emerg. Surg. 2010;16:27–32. PubMed
Slaninka I., Páral J., Chobola M., Motycka V., Ferko A., Bláha V. Peritonitidy způsobené perforací trávicí trubice--analýza gerontologické skupiny pacientů [Peritonitides caused by gastrointestinal perforations--analysis of an elderly patient group] Rozhl. Chir. 2009;88:656–661. (In Czech) PubMed
Nachiappan M., Litake M.M. Scoring Systems for Outcome Prediction of Patients with Perforation Peritonitis. J. Clin. Diagn. Res. 2016;10:PC01-5. doi: 10.7860/JCDR/2016/16260.7338. PubMed DOI PMC
Sharma R., Ranjan V., Jain S., Joshi T., Tyagi A., Chaphekar R. A prospective study evaluating utility of Mannheim peritonitis index in predicting prognosis of perforation peritonitis. J. Nat. Sci. Biol. Med. 2015;6((Suppl. S1)):S49–S52. doi: 10.4103/0976-9668.166076. PubMed DOI PMC
Sharma S., Singh S., Makkar N., Kumar A., Sandhu M.S. Assessment of Severity of Peritonitis Using Mannheim Peritonitis Index. Niger. J. Surg. 2016;22:118–122. doi: 10.4103/1117-6806.189009. PubMed DOI PMC
Muralidhar V.A., Madhu C.P., Sudhir S. Efficacy of Mannheim Peritonitis Index (MPI) Score in Patients with Secondary Peritonitis. J. Clin. Diagn. Res. 2014;8:NC01-3. doi: 10.7860/JCDR/2014/8609.5229. PubMed DOI PMC
Seymour C.W., Liu V.X., Iwashyna T.J., Brunkhorst F.M., Rea T.D., Scherag A., Rubenfeld G., Kahn J.M., Shankar-Hari M., Singer M., et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA. 2016;315:762–774. doi: 10.1001/jama.2016.0288. PubMed DOI PMC
Petersen S., Huber M., Storni F., Puhl G., Deder A., Prause A., Schefold J.C., Doll D., Schober P., Luedi M.M. Outcome in patients with open abdomen treatment for peritonitis: A multidomain approach outperforms single domain predictions. J. Clin. Monit. Comput. 2021 doi: 10.1007/s10877-021-00743-8. epub ahead of print . PubMed DOI PMC
Daabiss M. American Society of Anaesthesiologists physical status classification. Indian J. Anaesth. 2011;55:111–115. doi: 10.4103/0019-5049.79879. PubMed DOI PMC
Farrow S.C., Fowkes F.G., Lunn J.N., Robertson I.B., Samuel P. Epidemiology in anaesthesia II: Factors affecting mortality in hospital. Br. J. Anaesth. 1982;54:811–817. doi: 10.1093/bja/54.8.811. PubMed DOI
Claudio A.R., Wagner M., Sigurdsson G., Schilling M., Buchler M. The ASA-Physical Status Classification Predicts not only Short- Term but also Long-Term Outcome in Patients Undergoing Liver Resection; Proceedings of the ASA Annual Meeting Abstracts 2008; Boston, MA, USA. 1–4 August 2008; p. A1183.
Casal Núñez J.E., Ruano Poblador A., García Martínez M.T., Carracedo Iglesias R., Del Campo Pérez V. Morbilidad y mortalidad tras la intervención de Hartmann por peritonitis de origen diverticular (grados III-IV de Hinchey) [Morbidity and mortality after a Hartmann operation due to peritonitis originating from a sigmoid diverticulum disease (Hinchey grade III-IV)] Cir. Esp. 2008;84:210–214. doi: 10.1016/s0009-739x(08)72621-6. (In Spanish) PubMed DOI
Anwar M.A., D’Souza F., Coulter R., Memon B., Khan I.M., Memon M.A. Outcome of acutely perforated colorectal cancers: Experience of a single district general hospital. Surg. Oncol. 2006;15:91–96. doi: 10.1016/j.suronc.2006.09.001. PubMed DOI
Tartaglia D., Marin J.N., Nicoli A.M., De Palma A., Picchi M., Musetti S., Cremonini C., Salvadori S., Coccolini F., Chiarugi M. Predictive factors of mortality in open abdomen for abdominal sepsis: A retrospective cohort study on 113 patients. Updates Surg. 2021;73:1975–1982. doi: 10.1007/s13304-021-01012-8. PubMed DOI PMC
Oken M.M., Creech R.H., Tormey D.C., Horton J., Davis T.E., McFadden E.T., Carbone P.P. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am. J. Clin. Oncol. 1982;5:649–655. doi: 10.1097/00000421-198212000-00014. PubMed DOI
Analysis of Bacterial Pathogens Causing Complicating HAP in Patients with Secondary Peritonitis