Identification of Patients at Risk for Development of Tertiary Peritonitis on a Surgical Intensive Care Unit View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-04-08

AUTHORS

Ansgar M. Chromik, Andreas Meiser, Janine Hölling, Dominique Sülberg, Adrien Daigeler, Kirsten Meurer, Heike Vogelsang, Matthias H. Seelig, Waldemar Uhl

ABSTRACT

BackgroundTertiary peritonitis (TP) is defined as a severe recurrent or persistent intra-abdominal infection after adequate surgical source control of secondary peritonitis (SP). The aim of this study was to analyze the characteristics of patients with SP who will further develop TP in order to define early diagnostic markers for TP.Study DesignOver a 1-year period, all patients on the surgical intensive care unit (ICU) with SP were prospectively assessed for the development of TP applying the definition of the ICU consensus conference. The Mannheim Peritonitis Index (MPI), C-reactive protein (CRP) and Simplified Acute Physiology Score II (SAPS II) were assessed at the initial operation (IO) that was diagnostic for SP and in the postoperative period.ResultsAmong 69 patients with SP, 15 patients further developed TP, whereas 54 patients did not develop TP. Compared to SP, patients with transition to TP had significantly higher MPI at IO (28.6 vs. 19.8; p < 0.001), relaparotomy rate (2.00 vs. 0.11; p < 0.001), mortality (60% vs. 9%; p < 0.001), duration of ICU stay (14 vs. 4 days; p < 0.005), as well as SAPS II (45.1 vs. 28.4; p < 0.005) and CRP (265 mg/dL vs. 217 mg/dL; p < 0.05) on the second postoperative day after IO.ConclusionsThe MPI at IO as well as CRP and SAPS II at the second postoperative day helps to identify patients at risk for tertiary peritonitis. More... »

PAGES

1358-1367

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-009-0882-y

DOI

http://dx.doi.org/10.1007/s11605-009-0882-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1042430942

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19352781


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45 schema:description BackgroundTertiary peritonitis (TP) is defined as a severe recurrent or persistent intra-abdominal infection after adequate surgical source control of secondary peritonitis (SP). The aim of this study was to analyze the characteristics of patients with SP who will further develop TP in order to define early diagnostic markers for TP.Study DesignOver a 1-year period, all patients on the surgical intensive care unit (ICU) with SP were prospectively assessed for the development of TP applying the definition of the ICU consensus conference. The Mannheim Peritonitis Index (MPI), C-reactive protein (CRP) and Simplified Acute Physiology Score II (SAPS II) were assessed at the initial operation (IO) that was diagnostic for SP and in the postoperative period.ResultsAmong 69 patients with SP, 15 patients further developed TP, whereas 54 patients did not develop TP. Compared to SP, patients with transition to TP had significantly higher MPI at IO (28.6 vs. 19.8; p < 0.001), relaparotomy rate (2.00 vs. 0.11; p < 0.001), mortality (60% vs. 9%; p < 0.001), duration of ICU stay (14 vs. 4 days; p < 0.005), as well as SAPS II (45.1 vs. 28.4; p < 0.005) and CRP (265 mg/dL vs. 217 mg/dL; p < 0.05) on the second postoperative day after IO.ConclusionsThe MPI at IO as well as CRP and SAPS II at the second postoperative day helps to identify patients at risk for tertiary peritonitis.
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53 CRP
54 ICU stay
55 Mannheim Peritonitis Index
56 Peritonitis Index
57 SAPS II
58 Score II
59 TP
60 aim
61 care unit
62 characteristics
63 characteristics of patients
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66 control
67 days
68 definition
69 development
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71 duration
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73 identification
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79 intra-abdominal infections
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81 mortality
82 operation
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84 patients
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87 persistent intra-abdominal infection
88 postoperative day
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