Prognostic modelling in peritonitis. Peritonitis Study Group of the Surgical Infection Society Europe.
OBJECTIVE
To develop and to evaluate a new score to aid management in peritonitis.


METHODS
Prospective, multicentre study.


METHODS
18 departments of surgery in Germany. Austria, and Switzerland.


METHODS
355 patients with peritonitis confirmed at laparotomy.


METHODS
Computation of four different prognostic systems: APACHE II; APACHE II and successful operation; APACHE II, successful operation and Goris score on the first postoperative day: and multivariate analysis. Predictions were evaluated according to the following criteria: specificity with a fixed sensitivity at 80%, receiver operating characteristic (ROC-) curve, and predictive value.


METHODS
The ability to predict hospital death and infective complications.


RESULTS
Multivariate analysis was superior to APACHE II: APACHE II and successful operation: and APACHE II, successful operation, and Goris score. From the analysis a new prognostic model was derived from which it was possible to identify patients early in the postoperative period who are at high risk of developing further complications (prognostic peritonitis model: PPM).


CONCLUSIONS
None of the existing scores was of particular use for therapeutic decision making in peritonitis. The new prognostic model should be the focus of further trials in the management of peritonitis.
Ohmann
C
C
Department of General and Trauma Surgery, Heinrich-Heine-University, Düsseldorf, Federal Republic of Germany.
Yang
Q
Q
Hau
T
T
Wacha
H
H
D018806:APACHE; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010538:Peritonitis / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors