[Prognostic scores in peritonitis: the Mannheim Peritonitis Index or APACHE II?].
Scoring systems are mandatory to quantify the severity of abdominal sepsis on the basis of objective criteria. The Mannheim Peritonitis Index (MPI) is a disease-specific score based on easy to handle clinical parameters. APACHE II is a large-scale general scoring system with acute physiological and chronic health parameters. To evaluate the prognostic value of both systems 108 patients with severe abdominal infection managed by open treatment entered a prospective study. 32 patients (29.6%) died, 23 of them due to sepsis and 9 from other causes. Both MPI and APACHE II scores correlated closely with mortality, with three and two significantly different classes, respectively. Statistical validation showed a sensitivity of 93% and a specificity of 16% for MPI, and 89% and 25% for the APACHE II. ROC curves were nearly parallel for both scores. In conclusion there was no significant difference in prognostic value between the scoring systems.
1. Chirurgische Abteilung, Städtisches Krankenhaus München-Neuperlach.
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Demmel
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Muth
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Maag
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Osterholzer
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000145:classification* / Q000401:mortality / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D012720:Severity of Illness Index; D013530:Surgical Wound Infection / Q000145:classification* / Q000401:mortality / Q000601:surgery; D015996:Survival Rate
Prognosescores bei Peritonitis: Mannheimer Peritonitis-Index oder APACHE II?