학술논문
Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study
Document Type
Report
Author
Sartelli, Massimo; Abu-Zidan, Fikri M.; Labricciosa, Francesco M.; Kluger, Yoram; Coccolini, Federico; Ansaloni, Luca; Leppäniemi, Ari; Kirkpatrick, Andrew W.; Tolonen, Matti; Tranà, Cristian; Regimbeau, Jean-Marc; Hardcastle, Timothy; Koshy, Renol M.; Abbas, Ashraf; Aday, UlaÅ; Adesunkanmi, A. R. K.; Ajibade, Adesina; Akhmeteli, Lali; Akin, Emrah; Akkapulu, Nezih; Alotaibi, Alhenouf; Altintoprak, Fatih; Anyfantakis, Dimitrios; Atanasov, Boyko; Augustin, Goran; Azevedo, Constança; Bala, Miklosh; Balalis, Dimitrios; Baraket, Oussama; Baral, Suman; Barkai, Or; Beltran, Marcelo; Bini, Roberto; Bouliaris, Konstantinos; Caballero, Ana B.; Calu, Valentin; Catani, Marco; Ceresoli, Marco; Charalampakis, Vasileios; Jusoh, Asri Che; Chiarugi, Massimo; Cillara, Nicola; Cuesta, Raquel Cobos; Cobuccio, Luigi; Cocorullo, Gianfranco; Colak, Elif; Conti, Luigi; Cui, Yunfeng; De Simone, Belinda; Delibegovic, Samir; Demetrashvili, Zaza; Demetriades, Demetrios; Dimova, Ana; Dogjani, Agron; Enani, Mushira; Farina, Federica; Ferrara, Francesco; Foghetti, Domitilla; Fontana, Tommaso; Fraga, Gustavo P.; Gachabayov, Mahir; Gérard, Grelpois; Ghnnam, Wagih; Maurel, Teresa Giménez; Gkiokas, Georgios; Gomes, Carlos A.; Guner, Ali; Gupta, Sanjay; Hecker, Andreas; Hirano, Elcio S.; Hodonou, Adrien; Hutan, Martin; Ilaschuk, Igor; Ioannidis, Orestis; Isik, Arda; Ivakhov, Georgy; Jain, Sumita; Jokubauskas, Mantas; Karamarkovic, Aleksandar; Kaushik, Robin; Kenig, Jakub; Khokha, Vladimir; Khokha, Denis; Kim, Jae Il; Kong, Victor; Korkolis, Dimitris; Kruger, Vitor F.; Kshirsagar, Ashok; Simões, Romeo Lages; Lanaia, Andrea; Lasithiotakis, Konstantinos; Leão, Pedro; Arellano, Miguel León; Listle, Holger; Litvin, Andrey; Lizarazu Pérez, Aintzane; Lopez-Tomassetti Fernandez, Eudaldo; Lostoridis, Eftychios; Luppi, Davide; Machain V, Gustavo M.; Major, Piotr; Manatakis, Dimitrios; Reitz, Marianne Marchini; Marinis, Athanasios; Marrelli, Daniele; Martínez-Pérez, Aleix; Marwah, Sanjay; McFarlane, Michael; Mesic, Mirza; Mesina, Cristian; Michalopoulos, Nickos; Misiakos, Evangelos; Moreira, Felipe Gonçalves; Mouaqit, Ouadii; Muhtaroglu, Ali; Naidoo, Noel; Negoi, Ionut; Nikitina, Zane; Nikolopoulos, Ioannis; Nita, Gabriela-Elisa; Occhionorelli, Savino; Olaoye, Iyiade; Ordoéez, Carlos A.; Ozkan, Zeynep; Pal, Ajay; Palini, Gian M.; Papageorgiou, Kyriaki; Papagoras, Dimitris; Pata, Francesco; PÄdziwiatr, MichaÅ; Pereira, Jorge; Pereira Junior, Gerson A.; Perrone, Gennaro; Pintar, Tadeja; Pisarska, Magdalena; Plehutsa, Oleksandr; Podda, Mauro; Poillucci, Gaetano; Quiodettis, Martha; Rahim, Tuba; Rios-Cruz, Daniel; Rodrigues, Gabriel; Rozov, Dmytry; Sakakushev, Boris; Sall, Ibrahima; Sazhin, Alexander; Semião, Miguel; Sharda, Taanya; Shelat, Vishal; Sinibaldi, Giovanni; Skicko, Dmitrijs; Skrovina, Matej; Stamatiou, Dimitrios; Stella, Marco; StrzaÅka, Marcin; Sydorchuk, Ruslan; Teixeira Gonsaga, Ricardo A.; Tochie, Joel Noutakdie; Tomadze, Gia; Ugoletti, Lara; Ulrych, Jan; Ãmarik, Toomas; Uzunoglu, Mustafa Y.; Vasilescu, Alin; Vaz, Osborne; Vereczkei, Andras; Vlad, Nutu; WalÄdziak, Maciej; Yahya, Ali I.; Yalkin, Omer; Yilmaz, Tonguç U.; Ãnal, Ali Ekrem; Yuan, Kuo-Ching; Zachariah, Sanoop K.; Žilinskas, Justas; Zizzo, Maurizio; Pattonieri, Vittoria; Baiocchi, Gian Luca; Catena, Fausto
Source
World Journal of Emergency Surgery. July 15, 2019, Vol. 14 Issue 1
Subject
Language
English
ISSN
1749-7922
Abstract
Author(s): Massimo Sartelli[sup.1] , Fikri M. Abu-Zidan[sup.2] , Francesco M. Labricciosa[sup.3] , Yoram Kluger[sup.4] , Federico Coccolini[sup.5] , Luca Ansaloni[sup.5] , Ari Leppäniemi[sup.6] , Andrew W. Kirkpatrick[sup.7] , Matti Tolonen[sup.6] [...]
Background Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. Methods This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018. Results A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate [greater than or equai to] 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO.sub.2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8. Conclusions The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality. Keywords: Acute peritonitis, Source control, Early warning score, Emergency surgery
Background Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. Methods This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018. Results A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate [greater than or equai to] 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO.sub.2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8. Conclusions The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality. Keywords: Acute peritonitis, Source control, Early warning score, Emergency surgery