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2008, Number 5

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Cir Cir 2008; 76 (5)

Prognostic factors in intensive care unit patients with secondary diffuse peritonitis

González-Aguilera JC, Jiménez-Paneque RE

Language: Spanish
References: 25
Page: 399-407
PDF size: 60.75 Kb.


ABSTRACT

Objective: We undertook this study to identify and quantify the influence of different factors hypothetically related with patient evolution regarding the prognosis of patients with secondary diffuse peritonitis and to validate a function of prognostic factors, which permits us to predict its evolution to death.
Methods: A cohort, prospective, longitudinal study was carried out. Two hundred nineteen consecutive patients admitted to an intensive care unit (ICU) were included. Age, gender, physical status according to the American Society of Anesthesiologists (ASA), previous disease, heart rate, breathing rate, blood pressure, leukocytes, serum creatinine, etiology of peritonitis, anatomic origin, time of evolution, shock presence, bacteremia, and the number of organs with dysfunction were evaluated in the first 24 h of admission as possible prognostic factors. As a variable prognostic marker, death in the ICU was considered.
Results: A logistic regression model demonstrated that the number of organs with dysfunction (OR = 18.892, 95% CI = 2.48-143.572), physical status (OR = 6.228, 95% CI = 2.05-18.95), and time of evolution (OR = 1.035, 95% CI = 1.007-1.065) showed an independent relationship with death.
Conclusions: When the capacity of the model of prognostic factors was proven and estimated by the step-by-step method, an area under the ROC curve was found of 0.962 (CI 95% = 0.928-0.995). Sensitivity to predict death was 97%, and specificity was 92%. Higher negative predictive values were obtained (‹0.94). Physical status and time of evolution were included in this model.


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