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2002, Number 4

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Cir Cir 2002; 70 (4)

Mannheim Peritonitis Index Validation Study at the Hospital General de Durango (Mexico)

Bracho-Riquelme RL, Melero-Vela A, Torres-Ramírez A

Language: English
References: 56
Page: 217-225
PDF size: 71.79 Kb.


ABSTRACT

A study to confirm the predicative value of the Mannheim peritonitis index (MPI) among patients at the Hospital General de Durango was undertaken to evaluate the severity of peritonitis and to make a prognosis of survival-mortality pondering each risk factor. The simplicity of MPI makes it ideal for hospitals with serious shortages such as those in Mexico). From March 1 to November 30, 1999, 176 cases were studied. Patients were divided into groups according to the following categories (MPI points): a)‹ 21, 21 – 29 and ›29, and b) ≤26 and ›26. A life table was constructed to compare patient survival with peritonitis severity. Odds ratios that analyzed presence or absence of each adverse factor and outcome were calculated. Survival curves of the three subgroups (‹21, 21 – 29, and ›29) had differences that were statistically significant (p ‹ 0.0001). Patients with ›26 points had a mortality rate of 40%, whereas patients with ≤26 MPI points did not reach a 3% mortality rate. All MPI adverse factors, except of colonic origin, behaved as expected, and the following were especially useful: organic failure; time elapsed >24 h; malignancy; age >50 years, and generalized peritonitis.


REFERENCES

  1. Maddaus MA, Ahrenholz D, Simmons RL. Biología de la peritonitis. Surg Clin North Am 1988;2:471-485.

  2. Wittmann DH, Walker AP, Condon RE. Peritonitis e infección intraabdominal. In: Schwartz SI, Shires GT, Spencer FC, Husser WC, Editors. Principios de cirugía. 6th ed. México: McGraw-Hill, Inc.; 1994.Pp.1493-1528.

  3. Clinical files, Hospital records, Hospital General de Durango, SSD.

  4. Rodea-Rosas H, Athié-Gutiérrez C, Guízar-Bermúdez C, Zaldívar-Ramírez R, Flores-Martínez J. Experiencia en el tratamiento integral de 602 pacientes con sepsis abdominal. Cir Gen 1999;21:131-35.

  5. Caballero RF, Acosta R, Ortíz Villalba JO. Peritonitis agudas. In: Ferreira ML, coordinator. Primeras jornadas anuales de médicos, internos, y residentes. s.l, México: Instituto de Investigación en Ciencias de la Salud;1989.Pp.567-585.

  6. Pacelli F, Battista DG, Alfieri S, Piccioni E, Sgadari A, Gui D, et al. Prognosis in intra-abdominal infections. Arch Surg 1996;131(6): 641-645.

  7. Barriere SL, Lowry SF. An overview of mortality risk prediction in sepsis. Crit Care Med 1995;23(2):376-393.

  8. Koperna T, Schulz F. Prognosis and treatment of peritonitis. Do we need new scoring systems? Arch Surg 1996;131:180-186.

  9. Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Berger M, Bastos PG, et al. The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991;100(6):1619-1636.

  10. Sawyer RG, Rosenlof LK, Adams RB, May AK, Spengler MD, Pruett TL. Peritonitis into the 1990s: changing pathogens and changing strategies in the critically ill. Am Surg 1992 Feb;58(2):82-87.

  11. Lemeshow S, Teres D, Spitz Avrunin J, Pastides H. A comparison of methods to predict mortality of intensive care unit patients. Crit Care Med 1987;15(8):715-722.

  12. Velásquez-Díaz G, coordinator. Lineamientos y criterios de estructura progresiva para la integración de recursos humanos en hospitales generales de 30 a 180 camas censables. s.l.: Dirección de Desarrollo de los Servicios de Salud. Dirección General de Regulación de los Servicios de Salud. Subsecretaría de Regulación y Fomento Sanitario. México: Secretaría de Salud;2000:Pp.77-83.

  13. Dirección General de Estadística e Informática. Directorio de Unidades 1999. México, D.F.: Secretaría de Salud; 2000.

  14. Linder MM, Wacha H, Feldmann U, Wesch G. Streifensand RA, Gundlach E. Der Mannheimer peritonitis-index. Ein instrument zur intraoperativen prognose der peritonitis. Chirurg 1987;58(2):84–92.

  15. Billing A, Fröhlich D, Schildberg FW. Prediction of outcome using the Mannheim peritonitis index in 2003 patients. Br J Surg 1994;81: 209-213.

  16. Zeitoun G, Laurent A, Rouffet F, Hay J, Fingerhut A, Paquet J, Peillon C, Research TF. Randomized clinical trial: multicentre, randomized clinical trial of primary versus secondary sigmoid resection in generalized peritonitis complicating sigmoid diverticulitis. Br J Surg 2000 Oct;87(10):1366-1374.

  17. Hut’an M, Poticny V, Balaz P. Modern trends in the treatment of diffuse peritonitis. Rozhl Chir 2000 Apr;79(4):171-174.

  18. Seiler CA, Brugger L, Forssmann U, Baer HU, Buchler MW. Conservative surgical treatment of diffuse peritonitis. Surgery 2000 Feb;127(2):178-184.

  19. Yilmazlar T, Toker S, Zorluoglu A. Non-traumatic colorectal perforations. Int Surg 1999 Apr-Jun;84(2):155-158.

  20. Bergamaschi R, Marvik R, Johnsen G, Thoresen JE, Ystgaard B, Myrvold HE. Open vs laparoscopic repair of perforated peptic ulcer. Surg Endosc 1999 Jul;13(7):679-682.

  21. Brugger LE, Seiler CA, Mittler M, Balsiger B, Feodorovici M, Baer HU, Buchler MW. New approaches to the surgical treatment of diffuse peritonitis. Zentralbl Chir 1999;124(3):181-186.

  22. Seiler CA, Brugger L, Maurer CA, Renzulli P, Buchler MW. Peritonitis in diverticulitis: the Bern concept. Zentralbl Chir 1998;123(12): 1394-1394.

  23. Liverani A, Correnti SF, Paganelli MT, Antonini G, Mercati U. Mannhein index in the prognosis and treatment of acute peritonitis. Minerva Chir 1998 May;53(5):385-389.

  24. Moesgaard F, Jensen LS, Christiansen PM, Thorlacius-Ussing O, Nielsen KT, Rasmussen NR, Bardram L, Nielsen HJ. The effect of ranitidine on postoperative infectious complications following emergency colorectal surgery: a randomized, placebo-controlled, double-blind trial. Inflamm Res 1998 Jan;47(1):12-17.

  25. Bosscha K, Reijnders K, Hulstaert PF, Algra A, van der Werken C. Prognostic scoring systems to predict outcome in peritonitis and intra-abdominal sepsis. Br J Surg 1997 Nov;84(11):1532-1534.

  26. Ohmann C, Hau T. Prognostic indices in peritonitis. Hepatogastroenterology 1997 Jul-Aug;44(16):937-946.

  27. Grunau G, Heemken R, Hau T. Predictors of outcome in patients with postoperative intra-abdominal infection. Eur J Surg 1996 Aug;162(8):619-625.

  28. Gotzinger P, Gebhard B, Wamser P, Sautner T, Huemer G, Fugger R. Revision of diffuse peritonitis: planned versus on demand. Langenbecks Arch Chir 1996;381(6):343-347.

  29. Ermolov AS, Bagdat’ev VE, Chudotvortseva EV, Rozhnov AV. Evaluation of the Mannheim peritonitis index. Vestn Khir Im I I Grek 1996;155(3):22-23.

  30. Burger JA, Schoffel U, Sach M, Jacobs E, Kownatzki E, von Specht BU, Farthmann EH. Effects of peritonitis exudates on chemotaxis and phagocytosis of human neutrophils. Eur J Surg 1995 Sep;161(9):647-653.

  31. Schoeffel U, Jacobs E, Ruf G, Mierswa F, von Specht BU, Farthmann EH. Intraperitoneal micro-organisms and the severity of peritonitis. Eur J Surg 1995 Jul;161(7):501-508.

  32. Demmel N, Maag K, Osterholzer G. The value of clinical parameters for determining the prognosis of peritonitis-validation of the Mannheim Peritonitis Index. Langenbecks Arch Chir 1994;379(3):152-158.

  33. Demmel N, Muth G, Maag K, Osterholzer G. Prognostic scores in peritonitis: the Mannheim Peritonitis Index or APACHE II? Langenbecks Arch Chir 1994;379(6):347-352.

  34. Nespoli A, Ravizzini C, Trivella M, Segala M. The choice of surgical procedure for peritonitis due to colonic perforation. Arch Surg 1993 Jul;128(7):814-818.

  35. Ohmann C, Wittmann DH, Wacha H. Prospective evaluation of prognostic scoring systems in peritonitis. Peritonitis Study Group. Eur J Surg 1993 May;159(5):267-74.

  36. Altaca G, Sayek I, Onat D, Cakmakci M, Kamiloglu S. Risk factors in perforated peptic ulcer disease: comparison of a new score system with the Mannheim Peritonitis Index. Eur J Surg 1992 Apr;158(4): 217-221.

  37. Rogy M, Fugger R, Schemper M, Koss G, Schulz F. The value of 2 distinct prognosis scores in patients with peritonitis. The Mannheim peritonitis index versus the Apache II score. Chirurg 1990 Apr;61(4):297-300.

  38. Krenzien J, Lorenz W. Scoring systems for severe intra-abdominal infections. Zentralbl Chir 1990;115(17):1065-1079.

  39. Eypasch E, Spangenberger W, Bouillon B, Moser KH, Vestweber KH, Troidl H. Score systems, their importance for the intensive care patient. Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir 1989;813-817.

  40. Fugger R, Rogy M, Herbst F, Schemper M, Schulz F. Validation study of the Mannheim Peritonitis Index. Chirurg 1988 Sep;59(9):598-601.

  41. Schirrmacher E, Seifert J. The Mannheim peritonitis index. Its reliability for the assessment of prognosis in peritonitis patients. Fortschr Med 1988 Jul 30;106(22):454-456.

  42. Sautner T, Götzinger, Redl-Wenzl EM, Dittrich K, Felfernig M, Sporn P, et al. Does reoperation for abdominal sepsis enhance the inflammatory host response? Arch Surg 1997;132:250-255.

  43. Navez B, Tassetti V, Scohy JJ, Mutter D, Guiot P, Evrard S, et al. Laparoscopic management of acute peritonitis. Br J Surg 1997;85: 32-36.

  44. Rodloff AC, Kujath P, Lunstedt B, Gaus W. Vergleichende untersuchung zum kosten-/effektivitatsverhaltnis einer initialen therapie mit imipenem/cilastin bei der sekundaren peritonitis. Chirurg 1998;69(10): 1093-1100.

  45. Kriwanek S, Gschwntler M, Beckerhinn P, Armbruster C, Roka R. Langzeitergebnisse nach Hartmann-operationen. Chirurg 1999;70(1): 49-53.

  46. Bruch HP, Woltmann A, Eckmann C. Chirurgisches management bei peritonitis und sepsis. Zentralbl Chir 1999;124(3):176-180.

  47. Rodríguez-Gojón GH, Pérez-García R, Poblano-Morales M, Rodríguez-Brambilia V, Chavero-Garcia V. Factores pronósticos asociados a mortalidad en pacientes con sepsis abdominal tratados en la unidad de terapia intensiva. Cir Cir 1999;67(6):205-207.

  48. Demmel N, Osterholzer G, Gunther B. Differentiated treatment strategy for peritonitis: single stage closure with drainage or open with programmed reinterventrion/lavage? Zentralbl Chir 1993;1187(7): 395-400.

  49. Kriwanek S, Armbruster C, Beckerhinn P, Dittrich K. Prognostic factors for survival in colonic perforation. Int J Colorectal Dis 1994;9(3):158-162.

  50. Winkeltau GJ, Bertram P, Braun J, Schumpelick V. Differentiated surgical therapy of diffuse peritonitis–a prospective study. Leber Magen Darm 1996;26(3):144-148.

  51. Winkeltau GJ, Tons C, Bertram P, Schumpelick V. Stage-oriented antibiotic therapy of peritonitis. Langenbecks Arch Chir 1997;382(4 Suppl 1):S22-25.

  52. Tassetti V, Valvano L, Navez B, Mutter D, Scohy JJ, Evrard S, Marescaux J. Perforated peptic ulcer and laparoscopic treatment. Minerva Chir 1998;53(10):777-780.

  53. Yilmazlar T, Toker S, Zorluo glu A. Non traumatic colorectal perforations. Int Surg 1999;84(2):155-158.

  54. van Laarhoven CJ, Hoofwijk AG, van Vroonhoven TJ. The Mannheim peritonitis index: a valuable method in predicting the outcome of severe peritonitis? Neth J Surg 1988;40(6):168.

  55. Copes WS, Champion HR, Sacco WJ, Lawnick MM, Keast SL, Bain LW. The injury severity score revisited. J Trauma 1988;28(1):69-77.

  56. Farthmann EH, Schoffel U. Epidemiology and pathophysiology of intraabdominal infections (IAI). Infection 1998;26(5):329-334.




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