title: Prospective evaluation of prognostic scoring systems in peritonitis. Peritonitis Study Group.
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.
  
  
  METHODS
  Prospective, multicentre study.
  
  
  METHODS
  12 Departments of Surgery in Europe.
  
  
  METHODS
  271 Patients with peritonitis confirmed at laparatomy.
  
  
  METHODS
  Computation of the three scores on one set of data for each patient.
  
  
  METHODS
  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.affiliation: Department of General and Trauma Surgery, Heinrich-Heine-University, Düsseldorf, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Ohmann
authors.forename: D H
authors.initials: DH
authors.lastname: Wittmann
authors.forename: H
authors.initials: H
authors.lastname: Wacha
mesh_terms: D000328:Adult; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000145:classification* / Q000401:mortality / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index