Physiological parameters for prognosis in abdominal sepsis (PIPAS) study: a WSES observational study
Yükleniyor...
Dosyalar
Tarih
2019
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bmc
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
BackgroundTiming and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted.MethodsThis worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018.ResultsA total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate >= 22 breaths/min, systolic blood pressure < 100mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO(2)) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8.ConclusionsThe simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.
Açıklama
Anahtar Kelimeler
Acute Peritonitis, Source Control, Early Warning Score, Emergency Surgery
Kaynak
World Journal of Emergency Surgery
WoS Q Değeri
Q1
Scopus Q Değeri
Q1
Cilt
14
Sayı
Künye
Sartelli, M., Abu-Zidan, F. M., Labricciosa, F. M., Kluger, Y., Coccolini, F., Ansaloni, L., ... & Regimbeau, J. M. (2019). Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study. World journal of emergency surgery, 14(1), 34.
