RSS Cientifico geral Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study

  • Criador do t贸pico RCAAP Rss Feeder
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RCAAP Rss Feeder

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Breve resumo:
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. 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鈥墆ears (interquartile range [IQR] 28鈥66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6鈥塪ays (IQR 4鈥10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80鈥墆ears, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate 鈮 22 breaths/min, systolic blood pressure < 100鈥塵mHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4鈥塵mol/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鈥1, 22.7% for those who had scores of 2鈥3, 46.8% for those who had scores of 4鈥5, and 86.7% for those who have scores of 7鈥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.​



Info Adicional:
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. 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鈥墆ears (interquartile range [IQR] 28鈥66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6鈥塪ays (IQR 4鈥10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80鈥墆ears, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate 鈮 22 breaths/min, systolic blood pressure < 100鈥塵mHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4鈥塵mol/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鈥1, 22.7% for those who had scores of 2鈥3, 46.8% for those who had scores of 4鈥5, and 86.7% for those who have scores of 7鈥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.



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