Which prognostic score for abdominal sepsis? Analysis of final results of PIPAS (Physiological Indicators for Prognosis in Abdominal Sepsis) study in a single center

https://doi.org/10.4081/joper.2018.106

Authors

  • Stefano Raimondo | stefanoraimondo1987@gmail.com General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena (FC), Italy.
  • Massimo Sartelli General Surgery Department, Macerata Hospital, Macerata, Italy.
  • Federico Coccolini General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena (FC), Italy.
  • Paola Fugazzola General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena (FC), Italy.
  • Raffaele Bova General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena (FC), Italy.
  • Matteo Tomasoni General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena (FC), Italy.
  • Fausto Catena Emergency and Trauma Surgery Department, Maggiore Hospital, Parma, Italy.
  • Luca Ansaloni General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena (FC), Italy.

Abstract

Intra-abdominal infections (cIAIs) constitute an important cause of morbidity and mortality. Numerous risk factors may influence prognosis of cIAIs. This study aims to evaluate which parameters and scores may better predict prognostic outcomes in cIAIs. This is a single-center prospective observational study. Data from sixty-five patients were collected during a four-month period. Univariate and multivariate analysis for physiological parameters and ROC curves for SIRS, qSOFA and WISS scores were calculated in relation to mortality, intensive care unit (ICU) admission and surgical complications. Blood oxygen saturation level (SpO2), heart and respiratory rate, systolic blood pressure (SBP), level of consciousness, INR, C-reactive protein (CRP), white blood cells, source control and health care-acquired infections affect prognosis in cIAIs according to univariate analysis. On multivariate analysis level of consciousness, SpO2, CRP, diffuse peritonitis, INR and SBP significantly influenced prognosis in cIAIs. AUROC for WISS score were 0.89 for mortality, 0.86 for major complications, 0.76 for ICU admission. In our study many risk factors adversely affect prognostic outcomes in cIAIs; PIPAS study probably may provide even better results on that. Moreover, WISS score reached remarkable performance in predicting mortality and major surgical complications in abdominal sepsis; qSOFA did not achieve satisfactory results in none of analyzed outcomes.

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Published
2018-12-19
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Original Articles
Keywords:
Abdominal sepsis, secondary peritonitis, complicated intra-abdominal infections, prognosis.
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How to Cite
1.
Raimondo S, Sartelli M, Coccolini F, Fugazzola P, Bova R, Tomasoni M, Catena F, Ansaloni L. Which prognostic score for abdominal sepsis? Analysis of final results of PIPAS (Physiological Indicators for Prognosis in Abdominal Sepsis) study in a single center. J Peritoneum [Internet]. 2018Dec.19 [cited 2020Sep.22];3(1). Available from: http://www.jperitoneum.org/index.php/joper/article/view/106

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