Details
Category: Volume 06 Issue 08 August 2018
Hits: 1327

Title: To Study the Prognostic Factors and Management of Peritonitis

Authors: Dr Y Tej Kumar, Dr Narendranath Swain, Dr Supreet Kumar, Dr Manindra Nayak, Dr Jateen Anshuman

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.16

Abstract

Aim: To study the validity of scoring system, presently being studied worldwide.

These are:

  1. Mannheim peritonitis index.
  2. Sepsis score of Elebute and Stoner.

To study the prognostic factor which determine the outcome of the disease.

Materials and Methods: All patients diagnosed with peritonitis and admitted to SCB MEDICAL COLLEGE & HOSPITAL, Surgical Ward or who developed features of peritonitis due to various causes after being admitted between the period of August 2014 to July 2016.

Total number of cases studied – 100.

Observation: Duodenal perforation formed 73% (73) of the patients and 68% (27) of mortality. They had mortality rate of 33%. Both MPI and Sepsis score accurately predicted mortality and morbidity rates , patients whose MPI was ≤ 26 had low mortality rate of 7% whose MPI was > 26 had nearly 86% which was statistically significant ( P< 0.001). Similarly sepsis score of ≤ 20 had mortality of 7%, score > 20had mortality rate of 80% (P < 0.001).

Conclusion: There is wide scope for use of Mannheim peritonitis index, sepsis score of Elebute and Stoner in present context.

Keywords: Mannheim, sepsis score of Elebute, peritonitis.

References

  1. Billing A, Frohlich D, Schildberg F.W., Prediction of outcome using the Mannheim peritonitis index in 2003 patients. Peritonitis study group. Br.J.Surg 1994 Feb:81(2):209-13.
  2. Delinger P.E. etal. Surgical infection stratification system for intra-abdomina linfection. Arch.Surg.1985 Jan;120:21.
  3. Pacelli F, etal. Prognosis in intra-abdominal infectins. Multivariate analysis on 604 Arch Surg. 1996 June; 131(6):641-5
  4. Durham H. The mechanism of reaction to peritoneal infection. J. Pathol. Bacteriol. 1897;4:338-82.
  5. Melaney F.L. Olip J,et al. Peritonitis: II. Synergism of bacteria commonly found in peritoneal exudates. Arch Surg. 1932;25:709.
  6. Fry D.E. Garrison R.N. etal. Determinants of death in patients with intra abdominal abscess. Surgery. 1980;88:517.
  7. Elebute E.A., Stoner H.B. The grading of sepsis. Br.J.Surg.1983;70:29-31.
  8. Pine R.W. Wertz M.J. et.Al. Determinants of organ malfunction or death in patients within tra-abdominal sepsis. Arch Surg.1983; 118:242-249.
  9. Stevens L.E. Gauging the severity of surgical sepsis. Arch Surg. 1983;118:1190-1192.
  10. Knaus W.A, Draper E.A, Wagner D.P. etal. Prognosis in acute organ system failure. Ann. Surg.1985;202:685-693.
  11. Teichmann W. Wittmann D.H, etal. Scheduled reoperations (ettappenlavage) for diffuse peritonitis. Arch. Surg. 1986;121:147-152.
  12. H, Linder M.M, etal. Mannheim peritonitis index–prediction of risk of death from peritonitis; construction of astatic and validation of an empirically based index. The oritical Surgery 1987;1:169-77.
  13. Kohli V, etal. Evaluation of prognostic factors in perforated pepticulcer. Indian Journal of Surgery. 1988May-June; 50:184.
  14. Verma G.R. etal. Gastro-intestinal injuriesin abdominal trauma. Trop Gastroenterol 1990Oct-Dec;11(4):206-10.
  15. Demnel N. Muth G.,Maag K., Osterholzer G. Prognostics cores in peritonitis: the Mannheim peritonitis index or APACHEII? Langen becks Arch Chir1994;379(6):347-52.
  16. Dumont A.K, Mass W.K, etal. Increased survival from peritonitis after block adeoftrans-diaphragmatic absorption of bacteria. Surg. Gynecol Obstet. 1966;162 :248.
  17. Nyhus L.M, Baker R.J, etal. Ed. Master of Surgery, Little Brown and Company. 1997;146.
  18. Nystrom P.O. et al. Joint working party of SISN orth America and Europe. Proposed Definitions for Diagnosis. Severity Scoring, stratification and outcome for trials on intra abdominal infection. World J.Surg.1990; 14:148-158.
  19. Tripathi M.D. et al. Peritonitis–study of factors contributing to mortality. Indian Journal of Surgery.1993;55(7):342-349.
  20. Dandapat M.C., Mukherjee L.M., Mishra S. B., Howlader P.C. Gastrointestinal perforations. Indian Journal of Surgery, 1991;53 (5):189-93.

Corresponding Author

Dr Narendranath Swain

Associate Professor, Department of Surgery, SCB Medical College Cuttack, Odisha, India