A comparative study between Mannheim peritonitis index and APACHE II in predicting the outcome in patients of peritonitis due to hollow viscous perforation

Kumar, Pawanjeet; Singh, None Dr. K. B.; Kumar, Amarnath

doi:10.18203/2349-2902.isj20170215

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…9,10 According to Kumar et al, most common cause of perforation peritonitis was peptic ulcer perforation (36%) followed by typhoid ileal perforation (20%) followed by appendicular perforation (16%). 8 In present study highest incidence of SSI was seen in gastro duodenal perforations, 37.1% in control group and 20% in case group. There was a statistically significant reduction of SSI in the intervention group in case of duodenal and appendicular perforations at p<0.05.…”

Section: Discussionsupporting

confidence: 49%

“…There was no significant statistical difference in the mean age of the patients in case and control group. 8,9 In present study patients in age group of 18-30 years had 12% incidence of wound infection in case group and 20% incidence in control group. Patients in age group of 51-60 years had 16% surgical site infection rate in case group and 28.6% in control group.…”

Section: Discussionsupporting

confidence: 45%

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A prospective study on pattern of superficial surgical site infections in patients undergoing emergency laparotomy for perforation peritonitis

2020

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Background: surgical site infections (SSIs) are recognized as a common surgical complication occurring in about 3% of all surgical procedures and in upto 20% of patients undergoing emergency intraabdominal procedures. Aims: To determine the incidence of SSIs in emergency laparotomies done for perforation peritonitis and the organisms involved and their sensitivity pattern in superficial SSI. The objective of the study was to determine the effect of planned intra operative intervention [antibiotic lavage with III generation cephalosporin e.g. ceftriaxone 1 gm and metronidazole 100 ml (5 mg per ml)] on superficial surgical site infection in emergency laparotomies done for perforation peritonitis.Methods: This prospective randomized case controlled study was carried out in P. G. Department of Surgery, S. R. N. Hospital associated with M. L. N. Medical College, Allahabad, from September 2018 to August 2019 after approval from the ethical committee and after obtaining written and informed consent either from patient or their guardian. Patients were divided into two groups viz. control group receiving the normal saline lavage and case group receiving the antibiotic lavage (III generation cephalosporins i.e., ceftriaxone (1 gm in 1000 ml NS) and metronidazole- 5 mg/ml (100 ml in 500 ml NS).Results: There is almost 50% incidence of SSI in emergency laparotomy done for perforation peritonitis. The most common organism involved in superficial SSI in present study was gut flora (E. coli) followed by normal skin colonizer (Staph. aureus).Conclusions: Intraperitoneal antibiotic lavage has a significant role in reducing the rate of SSI especially in gastroduodenal perforations.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionsupporting

confidence: 45%

A prospective study on pattern of superficial surgical site infections in patients undergoing emergency laparotomy for perforation peritonitis

2020

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“…Rajendra Singh Jhobta et al (Kumar et al, 2017), in their study, observed 84% of males as the majority for Perforation Peritonitis. Similarly, Ranjan et al (2015) found 52% males and 48% females.…”

Section: Literature Reviewmentioning

confidence: 84%

MPI score assessment of perforation peritonitis patients

Saygaonkar

Nerlekar

2020

ijrps

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The most widespread clinical emergency in India is perforation peritonitis. Following improvements in operational procedures, antimicrobial treatments, and care in ICUs, peritonitis control is often very complicated, complicated, and challenging. MPI provides the highest precision of risk-assessment such that specific predictions for patients with peritonitis could be estimated. The objective of this research is to determine the prognosis for perforated peritonitis patients using the peritonitis index from Mannheim. It is also targeted at a) assessing the results in Mannheim peritonitis test perforation cases b) evaluating elevated incidents of perforated peritonitis on the Peritonitis Scale with Mannheim. C) Determining the function of the Mannheim Peritonitis Index in decision-making on peritonitis surgery. This research measured the diagnosis of perforated peritonitis patients utilizing peritonitis score of Mannheim’s Index. In the present study, we observed that the majority of the study subjects were males (65.38%), and many of the cases ranged from the age group of 46-55 years (25%), as well as 36-45 years (23.07%). The majority of the cases had duodenal perforation (42.30%), followed by gastric perforation (28.84%), appendicular perforation (13.46%), filial perforation (9.61%), jejunal (3.8%), colonic perforation (1.9%). We observed that the majority of the study subjects reported the MPI score between 21-29 (46.15%), followed by (38.46%) cases who reported MPI score of more than 29, and 15.38% who reported MPI score less than 21.

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“…For more precise risk stratification, surgeons should use both the APACHE II and MPI scores. 24 Several studies have shown that laparoscopic reintervention for colorectal anastomosis leaks is feasible and safe. 6,7,[25][26][27] Laparoscopic reintervention was recently added to the International Study Group of Rectal Cancer (ISREC) classification as a possible therapeutic alternative.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Reintervention for Intraperitoneal Leaks After Colonic Surgery: Do We Need a Routine Stoma?

Chen

Fingerhut²,

Tsai

et al. 2022

Surg Innov

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Introduction No universal consensus exists on the management of intraperitoneal anastomosis leakage after colonic surgery. The aim of the study was to evaluate the outcomes of laparoscopic reintervention without stoma creation for intraperitoneal leaks after colonic surgery. Material and Methods Single tertiary center study conducted from January 2010 to December 2020. 54 patients with intraperitoneal leakage were divided into 2 groups according to whether they received a stoma (n = 37) or not (n = 17) during laparoscopic reintervention. Short term outcome was analyzed. Results Patients in the no stoma group had lower American Society of Anesthesiologists (ASA) score ( P = .009), lower Acute Physiology And Chronic Health Evaluation II (APACHE II) score (5 vs. 10; P < .001) compared with the stoma group. Intensive care unit admission (43.2% vs. 5.8%; P = .006) and major complications (35.1% vs. 5.8%; P = .015) occurred more in the stoma group compared to the no stoma group. After multivariate logistic regression analysis, initial surgical procedure ( P = .001) and APACHE II score ( P = .039) were significant predictors of no stoma. The APACHE II score( P = .035) was an independent predictor of major complications. Finally, Receiver Operating Characteristic curve analysis showed that the cutoff value of APACHE II score for no stoma was 7.5. Conclusions In our study, APACHE II score was an independent predictor of stoma formation and the cutoff value of APACHE II score for no stoma was 7.5. Our results need to be confirmed by larger and randomized studies. In particular, a specific APACHE II threshold to omit a stoma in this setting remains to be determined.

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A comparative study between Mannheim peritonitis index and APACHE II in predicting the outcome in patients of peritonitis due to hollow viscous perforation

Cited by 7 publications

References 6 publications

A prospective study on pattern of superficial surgical site infections in patients undergoing emergency laparotomy for perforation peritonitis

A prospective study on pattern of superficial surgical site infections in patients undergoing emergency laparotomy for perforation peritonitis

MPI score assessment of perforation peritonitis patients

Laparoscopic Reintervention for Intraperitoneal Leaks After Colonic Surgery: Do We Need a Routine Stoma?

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